Usefulness of White Blood Cell Count (WBCC) During Infection: a Comparison Between Hospitalized Geriatric and Young Groups.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 62
- 试验地点
- 1
- 主要终点
- Delta of wbcc
研究概览
简要总结
In the general population, increased WBCC and neutrophil count are widely used as markers for infection during inflammatory states 1. However, 32% of geriatric patients with an infection do not develop an increase in WBCC 2. The hypothesis is that with inflammation, geriatric patients have a misadapted response of the immune system (IS) 3.
Our recent retrospective study 4 has shown that total and differential WBCC were not correlated with infection in a geriatric hospitalized population. Therefore, WBCC does not seem to be a reliable marker for infection in geriatric hospitalized patients. The neutrophil/lymphocyte ratio, and CRP, seem to be better markers.
the aim of the study to investigate this hypothesis prospectively and assess the role of aging and chronic diseases (such as cardiovascular diseases (CVD) and risk factors (CVRF) 5, cytomegalovirus (CMV) infection 6, periodontitis 7, onychomycosis 8 ) in this process and assess the role of a geriatric assessment.
To assess the usefulness of WBCC in the diagnosis of infection in geriatric patients and to address the contribution of ongoing chronic co-morbidities and age to WBCC-kinetics during an acute inflammatory syndrome, young and geriatric hospitalized patients with an inflammatory syndrome with and without infection will be compared
详细描述
Study design Observational prospective study
The subjects Number of subjects 200 subjects: Average value CRP: group 1: 55; group 2: 84 Average standard deviation: 70.52 Power 80%: 158 deelnemers Power 90%: 202 deelnemers alpha = 0.05 2-sample T-test.
Inclusion criteria
Acute inflammation is defined as a CRP ≥ 10 mg/l. We will include 2 groups of participants:
- A) A group with an inflammatory syndrome and infection; infection being defined as:
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Acute inflammation is defined as a CRP ≥ 10 mg/l. We will include 2 groups of participants:
- •A) A group with an inflammatory syndrome and infection; infection being defined as:
- •Viral infection confirmed by nasopharynx swab for: influenza, RSV, parainfluenza, rhinovirusses, coronavirusses.
- •Bacterial infection confirmed with positive blood culture, positive articular punction, positive expectorations, pneumonia on chest radiograph, or infection documented by abdominal imagery (CT or echo), a positive urine culture with a confirmed pyelonephritis with a renal echography or a DMSA scintigraphy or specific clinical symptoms for pyelonephritis and positive hemoculture. A positive urine culture alone is not considered as urine infection because of the high prevalence of asymptomatic bacteriuria in geriatric patients.
- •B) A group with inflammatory syndrome and inflammatory diseases without infection: defined as:
- •Confirmed pulmonary embolism (PE) by CT or ventilation-perfusion scintigraphy
- •Microcrystalline arthritis diagnosed by articular punction
- •Crush syndrome or rhabdomyolyses defined by history of a fall and raised creatine kinase in blood sample.
排除标准
- •Immunosuppressive therapy (NSAIDs, corticosteroids, chemotherapy, immunotherapy), active cancer, antibiotics before admission, hematological diseases
结局指标
主要结局
Delta of wbcc
时间窗: 1.5 years
the significance of a Delta of WBCC (Delta= □((White blood cell count during acute infection or acute inflammatory events)/(White blood cell count in chronic circumstances)) ) in geriatric patients with acute infections or inflammatory events
Usefulness of white blood cell count (WBCC) during infection in geriatric patient
时间窗: 1.5 years
observation of WBCC is correlated with infection by older patient
次要结局
未报告次要终点
研究者
Nathalie compté
Clinic head of geriatric unit
Universitair Ziekenhuis Brussel