Association of low white blood cell counts, comorbidities, and pneumonia in the surgical intensive care unit

Leukopenia and pneumonia in the surgical ICU

Abstract

Background and purpose: After the start of the COVID-19 pandemic, emergency admissions to the intensive care unit (ICU) have increased. These patients are often in poor general condition with frequent infections, especially pneumonia. Leukopenia may be associated with infections and a poorer treatment outcome in ICU patients. The aim of this study is to investigate the association of leukopenia with pneumonia, length of mechanical ventilation, length of ICU stay, and mortality in the ICU.

Materials and methods: Comorbidity, frequency of pneumonia, and duration of mechanical ventilation (MV) were compared in patients with leukopenia (LP group; n = 58) and a control group (n = 282) of surgical ICU patients.

Results: Patients with LP were more likely to be female (55% vs. 31%, P = 0.002), had a higher prevalence of respiratory disease (38% vs. 15.9%), gastrointestinal disease (74% vs. 51) and sepsis (41: 19%%) in comparison to control (P<0.001). In the LP population, 39% of patients had pneumonia, whereas in the control population, the rate was 23.8% (P < 0.023). The median ICU stay was 6 (3-14) vs 3 (2-8) days, P < 0.001, and MV length was 47 (8.25-96) vs 13.9 (3.1-85.9) hours in LP and control patients.

Conclusion: Women and patients with respiratory and acute abdominal diseases are at higher risk of developing leukopenia. The incidence of sepsis and pneumonia is high in this population. Microbiological analysis of the causative agents of these infections must be performed promptly, and targeted antimicrobial treatment applied.