RESULTS Severity of frailty syndrome significantly correlated with post-surgical mortality rates and with many although not all post-surgical complications .
These relationships emerge in different type of surgical procedures and patients ' features .
BACKGROUND Frailty is a geriatric syndrome characterized by the clinical presentation of identifiable physical alterations and decreased physiological reserve .
The assessment of frailty syndrome has been recently related with post-surgical outcomes and overall mortality in older individuals .
Failure to normalize lymphopenia following trauma is associated with increased mortality, independent of the leukocytosis pattern
Introduction Following trauma and systemic inflammatory response syndrome ( SIRS ) , the typical response is an elevation of the total complete blood count ( CBC ) and a reduction of the lymphocyte count . This leukocytosis typically returns to normal within 48 hours . The persistence of a leukocytosis following trauma is associated with adverse outcomes . Although lymphocyte anergy and dysfunction following trauma is associated with increased risk for infection and sepsis , there is a paucity of data regarding the impact of a persistence of a low lymphocyte count in trauma patients . Methods This is a retrospective review of prospect ively collected data from trauma patients collected over the 5 years of September 2003 to September 2008 . Patients were included if the injury severity score ( ISS ) was > /=15 , and they survived at least 3 days . Demographic data , mechanism and injury severity score , mortality , and length of stay were collected from the medical record . Laboratory values for the first 4 hospital days were collected . Leukocyte , neutrophil and lymphocyte counts were extracted from the daily complete blood count ( CBC ) . Patients were then grouped based on response ( elevation/depression ) of each component of the CBC , and their return , or failure thereof , to normal . Proportional hazards regression with time-varying covariates as well as Kaplan-Meier curves were used to predict risk of death , time to death and time to healthy discharge based on fluctuations of the individual components of the CBC . Results There were 2448 patients admitted over the 5 years included in the analysis . When adjusting for age , gender and ISS the relative risk of death was elevated with a persistent leukocytosis ( 2.501 ( 95 % CI = 1.477 - 4.235 ) ) or failure to normalize lymphopenia ( 1.639 ( 95 % CI = 10.17 - 2.643 ) ) within the first 4 days following admission . Similar results were seen when Kaplan-Meier curves were created . Persistent lymphopenia was associated with shortest time to death . Paradoxically in survivors persistent lymphopenia was associated with the shortest time to discharge . Conclusions Persistently abnormal CBC responses are associated with a higher mortality following trauma . This is the first report noting that a failure to normalize lymphopenia in severely injured patients is associated with significantly higher mortality
RESULTS Severity of frailty syndrome significantly correlated with post-surgical mortality rates and with many although not all post-surgical complications .
These relationships emerge in different type of surgical procedures and patients ' features .
BACKGROUND Frailty is a geriatric syndrome characterized by the clinical presentation of identifiable physical alterations and decreased physiological reserve .
The assessment of frailty syndrome has been recently related with post-surgical outcomes and overall mortality in older individuals .