Evaluation of CD4+ T Lymphocyte Counts to Predict Survival of ICU Patients with Sepsis Using Sepsis‐3 Criteria: A Prospective Cohort Study

Abstract

Background. Sepsis remains a major health condition with a high mortality rate that may be related to immunosuppression. T lymphocyte subsets may reflect the immune function of sepsis patients. The purpose of this study was to investigate the predictive value of CD4+ T lymphocyte counts of ICU patients for their short‐term prognosis. Methods. We conducted a prospective, observational cohort study in a general ICU and enrolled patients with sepsis using the Sepsis‐3 criteria. Peripheral blood samples were collected within 24 hours of enrollment or measurement of blood cell analysis and biomarkers of CD4+ T lymphocytes and CD8+ T lymphocytes. Severity was classified by the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment (SOFA) scores. The primary outcome was 28‐day mortality. Results. A total of 100 patients with sepsis were enrolled and analyzed. CD4+ T lymphocyte counts gradually decreased based on 28‐day mortality (p < 0.001). Similarly, multivariate logistic regression analysis showed that only CD4+ T lymphocyte counts were an independent predictor of 28‐day mortality in sepsis patients. The area under the receiver operating characteristic curve of the combination of CD4+ T lymphocyte counts and the SOFA score was 0.78. Conclusion. Our study demonstrated that CD4+ T lymphocyte counts are associated with 28‐day mortality. A combination of CD4+ T lymphocyte counts with the SOFA score increased the predictive accuracy for 28‐day mortality.