ArticleThe journal of trauma and acute care surgery2015
Leukopenia is associated with worse but not prohibitive outcomes following emergent abdominal surgery.
Article in The journal of trauma and acute care surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Acute abdomen in the immunocompromised patient: WSES, SIS-E, WSIS, AAST, and GAIS guidelines.World journal of emergency surgery : WJES · 2021Guideline
- Postoperative complications in patients with chemotherapy-induced acute myeloid leukemia (Review).Oncology letters · 2026Review
- Periprosthetic Infection after Endoprosthetic Reconstruction for Femoral Bone Metastases: Incidence and Risk Factors, a Single Center Study.Clinics in orthopedic surgery · 2025Article
- Article
- Review of cancer therapies for the perioperative physician.Perioperative medicine (London, England) · 2023Review
- Infections of Tumor Prostheses: An Updated Review on Risk Factors, Microbiology, Diagnosis, and Treatment Strategies.Biology · 2023Review
- Morbidity and Mortality of Neutropenic Patients in Visceral Surgery: A Narrative Review.Cells · 2022Review
- Clinical features and significance of leukopenia occurring immediately after endovascular surgery.Journal of anesthesia · 2022Article
- Mesenteric Ischemia and Its Need for Timely Recognition and Management.Case reports in surgery · 2022Article
- Shift of Neutrophils From Blood to Bone Marrow Upon Extensive Experimental Trauma Surgery.Frontiers in immunology · 2022Article
- Appendectomy in pediatric patients with synchronous oncologic diagnosis is safe: an analysis using the national surgical quality improvement project, pediatric.Pediatric surgery international · 2020Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThere are little data currently available to guide surgical decision making regarding emergent surgical interventions in leukopenic patients. The purpose of this study was to investigate the impact of leukopenia among patients undergoing emergency abdominal operations to better guide preoperative decision making.
methodsThe 2005 to 2012 American College of Surgeons' National Surgical Quality Improvement Program database was queried to identify patients who underwent emergent laparotomy. Patients were stratified by preoperative white blood cell (WBC) count (<4.0 × 10(9)/L vs. 4.0-12.0 × 10(9)/L). Baseline demographics, comorbidities, and outcomes were compared. Multivariable logistic regression was performed to estimate the adjusted association between leukopenia and mortality, taking into account the robust array of patient-related factors.
resultsOf the 20,443 patients who met study criteria, 2,057 (8.2%) were leukopenic (WBC < 4.0) before surgery. Unadjusted comparison demonstrated significantly increased major morbidity (45.4% vs. 26.9%, p < 0.001) as well as mortality (24.4% vs. 10.8%, p < 0.001) for patients with leukopenia compared with patients with a normal preoperative WBC count. Only 46.0% (n = 947) of patients with leukopenia before surgery were able to avoid major morbidity or mortality compared with 69.4% (n = 15,974) of patients with a normal preoperative WBC count (p < 0.001). After multivariable adjustment for patient-related factors, leukopenia was maintained as a significant predictor of mortality.
conclusionAlthough leukopenia remains associated with mortality in patients undergoing emergent laparotomy despite adjustment for other patient-related factors, it is not necessarily prohibitive. Understanding the risk of complications and mortality associated with these procedures is pertinent for preoperative clinical decision making. LEVEL OF EVIDENCE: Prognostic and epidemiologic study, level III.
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