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Medicina interna de México

Print version ISSN 0186-4866

Abstract

TINOCO-SANCHEZ, M.; SUAREZ-CUENCA, JA.  and  RUBIO-GUERRA, AF.. Usefulness of eosinopenia as prognostic marker of severity in sepsis. Med. interna Méx. [online]. 2017, vol.33, n.5, pp.572-579. ISSN 0186-4866.  http://dx.doi.org/10.24245/mim.v33i5.1555.

BACKGROUND:

Sepsis is considered the leading cause of morbidity and mortality in critical patients, it is necessary to have prognostic markers of severity that are increasingly accessible and useful to guide treatment in a timely manner. Evidence demonstrates the usefulness of eosinopenia as a prognostic marker of severity. It has also been shown that eosinopenia may be associated with a higher mortality rate, probably due to the systemic inflammatory environment.

OBJECTIVE:

To evaluate the utility of low eosinophil counts as a prognostic marker of sepsis severity.

MATERIAL AND METHOD:

An observational, descriptive, longitudinal and prospective study was done in patients with diagnosis of sepsis of Xoco General Hospital, Mexico City. Data were recorded for registry such as age, sex, chronic-degenerative history, diagnosis, clinical severity of the patient by SOFA scale, and a temporal follow-up was recorded at admission and at 72 h, eosinophil counts and the arithmetic average were performed. Relative eosinopenia was considered with values below the mean of eosinophils. Subsequently, group allocation was performed according to eosinophil count elevation after 72 hours of treatment compared to baseline.

RESULTS:

Sixty patients with critical condition requiring multi-organ support were included. The majority were men and the average age was 51 years. Most patients (58%) had diabetes mellitus. When comparing the SOFA score of the group with eosinopenia vs no eosinopenia, significant differences were found, which seems to indicate that the eosinopenia factor has a direct clinical impact on the patient’s condition, that is, the group with eosinopenia presented greater tissue hypoperfusion or organic failure in comparison with the group without eosinopenia. A significant eosinophil elevation was found at 72 hours.

CONCLUSIONS:

Eosinopenia and improvement of eosinophils after 72 hours of treatment were related to the modification of severity of sepsis. This suggests its usefulness of eosinopenia as a predictor of severity of sepsis.

Keywords : sepsis; prognostic factor; eosinopenia; SOFA.

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