Table 1. MDSC Pattern is Associated with Functional Status at the Time of Discharge and Rate of Nosocomial Infection.
A. Patients were categorized into three MDSC expression patterns: “sustained low,” “decreasing,” and “sustained high” and as having either poor or successful dispositions. Patients were recognized as having distinct temporal patterns of MDSC expression: “sustained low”, “decreasing”, or “sustained high”. Patients were considered to have a “sustained low” MDSC expression pattern if MDSC levels were less than or equal to 30% of the total leukocyte count. Patients with a declining percentage of MDSCs, as indicated by a negative slope over time, were classified as “decreasing” MDSC pattern. The remaining patients had either persistently elevated MDSCs or an increasing percentage of MDSC as indicated by a positive slope; these patients were categorized as “sustained high” MDSC. Patients with “sustained high” levels of MDSCs have almost eight times the odds of having a poor disposition when compared with patients with “sustained low” MDSCs. This relationship remains significant after adjustment for APACHE II Score and presence of septic shock (OR 7.33). B. Patients with “sustained high” levels of MDSCs had almost seven times the odds of having nosocomial infections when compared with patients with “sustained low” MDSCs. Significant association remained after adjustment for age and number of comorbidities (OR 8.4). This suggests that high levels of circulating MDSC may make patients more vulnerable to nosocomial infection during hospitalization.
| A. Disposition Status | Unadjusted OR(95% CI) | Adjusted OR (95% CI) (AUC=0.79 95% CI 0.68–0.90) |
|---|---|---|
|
| ||
| Decreasing vs. Sustained Low | 2.80 (0.77, 10.18) | 2.70 (0.64, 11.29) |
| Sustained High vs. Sustained Low | 7.88 (1.56, 39.76)a | 7.33 (1.25, 43.12) a |
| Septic Shock | 3.61 (1.28, 1.19) a | 2.49 (0.79, 7.88) |
| Apache Score (per 1 unit increase) | 1.12 (1.04, 1.22) a | 1.12 (1.02, 1.22) a |
| B. Incidence of Nosocomial Infection | Unadjusted OR (95% CI) | OR (95% CI) (AUC=0.73 95% CI 0.61–0.85) |
|---|---|---|
|
| ||
| Decreasing vs. Sustained Low | 2.24 (0.69, 7.26) | 3.16 (0.86, 11.57) |
| Sustained High vs. Sustained low | 6.67 (1.32, 33.69) a | 8.40 (1.48, 47.53) a |
| Age (per 1 unit increase) | 0.97 (0.94, 1.01) | 0.98 (0.95, 1.02) |
| Number of comorbidities (per 1 unit increase) | 0.79 (0.61, 1.02) | 0.78 (0.58, 1.05) |
Abbreviations. OR, odds ratio; CI, confidence interval; AUC, area under the receiver operating characteristics curve.
p<0.05