Usefulness of White Blood Cell Count (WBCC) During Infection in Geriatric Patient

NCT03943277 | Completed

• 1 other identifier: UZCompte1
• Study Type: observational
• Target: 62
• Locations: 1 country
• Sites: 1

Brief Summary

In the general population, increased WBCC and neutrophil count are widely used as markers for infection during inflammatory states 1. However, 32% of geriatric patients with an infection do not develop an increase in WBCC 2. The hypothesis is that with inflammation, geriatric patients have a misadapted response of the immune system (IS) 3. Our recent retrospective study 4 has shown that total and differential WBCC were not correlated with infection in a geriatric hospitalized population. Therefore, WBCC does not seem to be a reliable marker for infection in geriatric hospitalized patients. The neutrophil/lymphocyte ratio, and CRP, seem to be better markers. the aim of the study to investigate this hypothesis prospectively and assess the role of aging and chronic diseases (such as cardiovascular diseases (CVD) and risk factors (CVRF) 5, cytomegalovirus (CMV) infection 6, periodontitis 7, onychomycosis 8 ) in this process and assess the role of a geriatric assessment. To assess the usefulness of WBCC in the diagnosis of infection in geriatric patients and to address the contribution of ongoing chronic co-morbidities and age to WBCC-kinetics during an acute inflammatory syndrome, young and geriatric hospitalized patients with an inflammatory syndrome with and without infection will be compared

Conditions

White Blood Cells Engulfing Red Blood Cells

Outcome Measures

Primary Outcomes (2)

• Usefulness of white blood cell count (WBCC) during infection in geriatric patient

  observation of WBCC is correlated with infection by older patient

  1.5 years

• Delta of wbcc

  the significance of a Delta of WBCC (Delta= □((White blood cell count during acute infection or acute inflammatory events)/(White blood cell count in chronic circumstances)) ) in geriatric patients with acute infections or inflammatory events

  1.5 years

Study Arms (2)

patient with infection

Acute inflammation is defined as a CRP ≥ 10 mg/l. We will include 2 groups of participants: A group with an inflammatory syndrome and infection; infection being defined as: 1. Viral infection confirmed by nasopharynx swab for: influenza, RSV, parainfluenza, rhinovirusses, coronavirusses. 2. Bacterial infection confirmed with positive blood culture, positive articular punction, positive expectorations, pneumonia on chest radiograph, or infection documented by abdominal imagery (CT or echo), a positive urine culture with a confirmed pyelonephritis with a renal echography or a DMSA scintigraphy or specific clinical symptoms for pyelonephritis and positive hemoculture. A positive urine culture alone is not considered as urine infection because of the high prevalence of asymptomatic bacteriuria in geriatric patients.

Other: No intervention, observational study

patient without infection

Acute inflammation is defined as a CRP ≥ 10 mg/l. We will include 2 groups of participants: =\> B) A group with inflammatory syndrome and inflammatory diseases without infection: defined as: 1. Confirmed pulmonary embolism (PE) by CT or ventilation-perfusion scintigraphy 2. Microcrystalline arthritis diagnosed by articular punction 3. Crush syndrome or rhabdomyolyses defined by history of a fall and raised creatine kinase in blood sample.

Other: No intervention, observational study

Interventions

No intervention, observational study OTHER

No intervention observational study

patient with infection; patient without infection

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Young and older patient with an inflammatory syndrome (CRP \> 10 mg/dl) with or without infection

You may qualify if:

• Acute inflammation is defined as a CRP ≥ 10 mg/l. We will include 2 groups of participants:
• A) A group with an inflammatory syndrome and infection; infection being defined as:
• Viral infection confirmed by nasopharynx swab for: influenza, RSV, parainfluenza, rhinovirusses, coronavirusses.
• Bacterial infection confirmed with positive blood culture, positive articular punction, positive expectorations, pneumonia on chest radiograph, or infection documented by abdominal imagery (CT or echo), a positive urine culture with a confirmed pyelonephritis with a renal echography or a DMSA scintigraphy or specific clinical symptoms for pyelonephritis and positive hemoculture. A positive urine culture alone is not considered as urine infection because of the high prevalence of asymptomatic bacteriuria in geriatric patients.
• B) A group with inflammatory syndrome and inflammatory diseases without infection: defined as:
• Confirmed pulmonary embolism (PE) by CT or ventilation-perfusion scintigraphy
• Microcrystalline arthritis diagnosed by articular punction
• Crush syndrome or rhabdomyolyses defined by history of a fall and raised creatine kinase in blood sample.

You may not qualify if:

• Immunosuppressive therapy (NSAIDs, corticosteroids, chemotherapy, immunotherapy), active cancer, antibiotics before admission, hematological diseases

Sponsors & Collaborators

• Universitair Ziekenhuis Brussel: lead

Study Sites (1)

UZ Brussel

Brussels, 1090, Belgium

Location

Related Publications (2)

• Compte N, Dumont L, Bron D, De Breucker S, Praet JP, Bautmans I, Pepersack T. White blood cell counts in a geriatric hospitalized population: A poor diagnostic marker of infection. Exp Gerontol. 2018 Dec;114:87-92. doi: 10.1016/j.exger.2018.11.002. Epub 2018 Nov 6.

  PMID: 30412726 RESULT

• Compte N, Bailly B, De Breucker S, Goriely S, Pepersack T. Study of the association of total and differential white blood cell counts with geriatric conditions, cardio-vascular diseases, seric IL-6 levels and telomere length. Exp Gerontol. 2015 Jan;61:105-12. doi: 10.1016/j.exger.2014.11.016. Epub 2014 Nov 22.

  PMID: 25446500 RESULT

MeSH Terms

Interventions

Observation

Intervention Hierarchy (Ancestors)

Methods; Investigative Techniques

Study Officials

• Compté Nathalie, Dr, PhD

  Universitair Ziekenhuis Brussel

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 2 Weeks
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinic head of geriatric unit

Study Record Dates

• First Submitted: April 25, 2019
• First Posted: May 9, 2019
• Study Start: May 20, 2019
• Primary Completion: June 30, 2024
• Study Completion: June 30, 2024
• Last Updated: December 5, 2024

Record last verified: 2024-12

Data Sharing

• IPD Sharing: Will not share

Locations

BE (1)