The Clinical Value of Comprehensive Nursing Intervention in Preventing Severe Lymphopenia and Improving the Survival Rate Among Patients with Sepsis

Figures & data

Figure 1 Patients screening flow diagram.

Table 1 General Clinical Characteristics of Sepsis Patients with Lymphopenia

Factors	Severe Lymphopenia (<600/uL)		All (n=192)	t / χ^2	P value
	With (n=77)	Without (n=115)
Age (years)	69.17±11.63	64.03±10.37	66.09±11.16	3.206	0.002
Sex
Female	37 (48.05)	60 (52.17)	97 (50.52)	0.313	0.576
Male	40 (51.95)	55 (47.83)	95 (49.48)
BMI (kg/m^2)	21.47±1.87	21.54±2.61	21.51±2.34	−0.201	0.841
Comorbidities
Diabetes	31 (40.26)	49 (42.6)	80 (41.67)	0.105	0.746
Congestive heart failure	6 (7.79)	13 (11.20)	19 (9.80)	0.608	0.436
Cerebrovascular disease	24 (31.17)	32 (27.83)	56 (29.17)	0.249	0.617
Chronic renal insufficiency	19 (24.68)	23 (20.00)	42 (21.88)	0.590	0.442
Chronic airway disease	30 (38.96)	35 (30.43)	65 (33.85)	1.497	0.221
Liver disease	5 (6.49)	8 (6.96)	13 (6.77)	0.016	0.900
≥ 2 above comorbidities	38 (49.35)	30 (26.09)	68 (35.42)	10.912	0.001
Infection
Yes	31 (40.26)	22 (19.13)	53 (27.60)	10.303	0.001
No	46 (59.74)	93 (80.87)	149 (72.40)
Septic shock
Yes	32 (41.56)	47 (40.87)	79 (41.15)	0.009	0.942
No	45 (58.44)	68 (59.13)	113 (58.85)
Smoker
Yes	27 (35.06)	33 (28.70)	60 (31.25)	0.871	0.351
No	50 (64.94)	82 (71.30)	132 (68.75)
SOFA score	8.53±1.98	7.79±1.89	8.12±2.03	2.611	0.010

Note: Font bold in P value < 0.05.

Table 2 Comparison of Outcomes of Sepsis Patients with Lymphopenia

Outcomes	Severe Lymphopenia (<600/uL)		All (n=192)	t / χ^2	P value
	With (n=77)	Without (n=115)
28-day mortality
Survivors	28 (36.36)	26 (22.61)	54 (28.13)	4.317	0.038
Non-survivors	49 (63.64)	89 (77.39)	138 (71.87)
1-year mortality
Survivors	35 (45.45)	29 (25.17)	64 (33.33)	8.500	0.004
Non-survivors	42 (54.55)	86 (74.83)	128 (67.67)
Length of stay in ICU	14.00±6.23	10.61±5.58	11.97±6.06	3.940	<0.001

Note: Font bold in P value < 0.05.

Figure 2 Receiver operator characteristic plot comparing the ability of absolute lymphocyte counts on the first 4 days after sepsis diagnosis to predict 28-day mortality.

Figure 3 Kaplan-Meier survival analysis of the patients with or without severe lymphopenia.

Table 3 Comparison of the General Information Between the Two Nursing Groups

Factors	Control Group (n=94)	Test Group (n=98)	All (n=192)	t / χ^2	P value
Age (years)	65.56±10.98	66.68±10.97	66.09±11.16	−0.707	0.481
Sex
Female	47 (50.00)	50 (51.00)	97 (50.52)	0.020	0.888
Male	47 (50.00)	48 (49.00)	95 (49.48)
BMI (kg/m^2)	21.46±2.76	21.55±1.86	21.51±2.34	−0.261	0.795
Comorbidities
Diabetes	37 (39.36)	43 (43.88)	80 (41.67)	0.403	0.526
Congestive heart failure	8 (8.51)	11 (11.22)	19 (9.80)	0.6396	0.529
Cerebrovascular disease	27 (28.72)	29 (29.59)	56 (29.17)	0.018	0.895
Chronic renal insufficiency	22 (23.40)	20 (20.41)	42 (21.88)	0.252	0.616
Chronic airway disease	31 (32.98)	34 (34.69)	65 (33.85)	0.063	0.802
Liver disease	6 (6.38)	7 (7.14)	13 (6.77)	0.044	0.834
≥ 2 above comorbidities	31 (32.98)	37 (37.76)	68 (35.42)	0.479	0.489
Infection
Yes	27 (28.72)	26 (26.53)	53 (27.60)	0.115	0.734
No	67 (71.28)	72 (73.47)	149 (72.40)
Septic shock
Yes	36 (38.30)	43 (43.88)	79 (41.15)	0.617	0.432
No	58 (61.70)	55 (56.12)	113 (58.85)
Smoker
Yes	27 (28.72)	33 (33.67)	60 (31.25)	0.547	0.459
No	67 (71.28)	65 (66.33)	132 (68.75)
SOFA score	8.19±2.03	8.05±2.03	8.12±2.03	0.479	0.632

Table 4 Comparison of Outcomes of Sepsis Patients in the Two Nursing Groups

Outcomes	Control Group (n=94)	Test Group (n=98)	All (n=192)	t / χ^2	P value
28-day mortality
Survivors	34 (36.17)	20 (20.41)	54 (28.13)	5.897	0.015
Non-survivors	60 (63.83)	78 (79.59)	138 (71.87)
1-year mortality
Survivors	39 (41.49)	25 (25.51)	64 (33.33)	5.513	0.019
Non-survivors	55 (58.51)	73 (74.49)	128 (67.67)
Length of stay in ICU	12.97±6.21	11.48±6.56	11.97±6.06	1.613	0.108

Note: Font bold in P value < 0.05.

Figure 4 Kaplan-Meier survival analysis between the the two nursing groups.

Table 5 Cox Proportional Hazard Regression Analysis for 28-Day Mortality

Factors	Univariate Analysis		Multivariate Analysis
	OR (95% CI)	P value	OR (95% CI)	P value
Age	0.980 (0.952–1.009)	0.173	NA
BMI	1.088 (0.955–1.239)	0.206	NA
SOFA	0.786 (0.657–0.941)	<0.05	NA
Length in ICU	1.086 (1.029–1.146)	<0.05	NA
Comorbidities	102.500 (32.427–323.999)	<0.05	8.419 (1.632–43.427)	0.011
Infection	328.300 (84.694–1272.598)	<0.05	74.139 (14.627–375.800)	<0.001
Smoker	1.241 (0.638–2.415)	0.525	NA

Note: Font bold in P value < 0.05.

Table 6 Comparison of the Number of Severe Lymphopenia Between the Two Nursing Groups

Severe Lymphopenia (<600/uL)	Control Group (n=94)	Test Group (n=98)	All (n=192)	χ^2	P value
With	47 (50.00)	30 (30.61)	77 (40.10)	7.508	0.006
Without	47 (50.00)	68 (69.39)	115 (59.90)

Note: Font bold in P value < 0.05.

Table 7 Comparison of Nursing Satisfaction Between the Two Nursing Groups

Nursing Satisfaction	Control Group (n=94)	Test Group (n=98)	All (n=192)	χ^2	P value
Satisfied	47 (50.00)	65 (63.27)	112 (58.33)	6.949	0.031
Generally satisfied	34 (36.17)	28 (31.63)	62 (32.29)
Unsatisfied	13 (13.83)	5 (5.10)	18 (9.38)

Note: Font bold in P value < 0.05.

Figure 5 The lymphocyte count under the two nursing methods.