Reactive leukocytosis in older patients with acute colonic diverticulitis: A retrospective study utilizing logistic regression analysis
| Autor: | Naoyasu Kashima, Yoshihisa Urita, Yosuke Sasaki, Tadashi Maeda, Fumiya Komatsu |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Immunosenescence Leukocytosis Logistic regression Diverticulitis Colonic Leukocyte Count Young Adult 03 medical and health sciences 0302 clinical medicine Japan 030502 gerontology Interquartile range Internal medicine neutrophilia Odds Ratio medicine Humans Original Article: Epidemiology Clinical Practice and Health Aged Retrospective Studies Aged 80 and over geriatrics business.industry Age Factors Retrospective cohort study Original Articles: Epidemiology Clinical Practice and Health Odds ratio Middle Aged Diverticulitis medicine.disease Neutrophilia Confidence interval diverticulitis Logistic Models Acute Disease Female medicine.symptom 0305 other medical science business 030217 neurology & neurosurgery |
| Zdroj: | Geriatrics & Gerontology International |
| ISSN: | 1447-0594 1444-1586 |
| DOI: | 10.1111/ggi.14027 |
| Popis: | Aim Although various neutrophilic immunosenescence mechanisms have been shown, there are few clinical studies on age-related differences in leukocytosis against acute bacterial infections, including acute colonic diverticulitis. Methods We performed a retrospective study of 26 patients ≥65 years old and 211 patients 16-64 years old who were hospitalized for acute colonic diverticulitis at Toho University Medical Center Omori Hospital between 2010 and 2016. We compared patients' characteristics, including sex, immunocompromised status, diverticulitis site, complications, severity, previous diverticulitis, vital signs, leukocyte counts, neutrophil-to-lymphocyte ratio and serum C-reactive protein on admission. To adjust for confounding factors, we performed a logistic regression analysis. Results Univariate comparisons showed that leukocyte count (older: 10 850 [interquartile range, 9400-12 000]/mm3 vs. younger: 12 600 [interquartile range, 10 500-15 000]/mm3 , P = 0.004) and prevalence of leukocytosis (leukocytes >11 000/mm3 ) were lower in older compared with younger patients. There were significantly more female, left-sided diverticulitis and immunocompromised patients in the older compared with the younger group. Logistic regression showed that leukocyte count, prevalence of female patients, and left-sided diverticulitis were independent predictors for the older patients: Their odds ratios were 0.866 (95% confidence interval [95% CI] 0.753-0.996), 2.631 (95% CI, 1.032-6.707) and 5.810 (95% CI, 2.328-14.497), respectively. Conclusion Caution should be taken when managing older patients with colonic diverticulitis because reactive leukocytosis might be poor, possibly reflecting immunosenescence. Geriatr Gerontol Int 2020; 20: 951-955. |
| Databáze: | OpenAIRE |
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