Evidence mapPaperPMID 42467654Full record

ArticlePloS one2026

Failure of early lymphocyte recovery identifies sepsis patients with initial lymphopenia at highest risk for late mortality.

Binli Ma, Gan Lin, Jinhu Li, Lian Xie, Jiale Yang, Huasheng Tong

Abstract read
In one paragraph

Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Binli MaGuangdong Pharmaceutical University, Guangzhou, China.
Gan LinGuangdong Pharmaceutical University, Guangzhou, China.
Jinhu LiGuangdong Pharmaceutical University, Guangzhou, China.
Lian XieDepartment of Critical Care Medicine, General Hospital of the Southern Theatre Command of the People's Liberation Army of China, Guangzhou, China.
Jiale YangDepartment of Critical Care Medicine, Chinese PLA General Hospital, Beijing, China.
Huasheng TongGuangdong Pharmaceutical University, Guangzhou, China.ORCID https://orcid.org/0000-0001-6916-2487

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSepsis-induced lymphopenia is associated with adverse outcomes, yet static assessments at a single time point fail to capture the clinical significance of its dynamic evolution, and the effects of the trajectories of lymphopenia on prognosis are to be elucidated in sepsis.

methodsThis retrospective cohort study extracted data from the MIMIC-IV (v3.1) database. Adult septic patients with initial lymphopenia (<1.0 × 10⁹/L) were included. Group-Based Trajectory Modeling (GBTM) identified lymphocyte count trajectories. Kaplan-Meier analysis with log-rank test was used to visualize survival differences. Multivariable Cox and logistic regression assessed associations between trajectories and 7-day, 28-day, ICU, and in-hospital mortality. Subgroup analyses validated result consistency.

resultsA total of 1,640 patients were included. GBTM identified 4 distinct lymphocyte count trajectories. Kaplan-Meier analysis revealed that patients in Trajectory 4 (Persistent Low Level, N = 544, 33.2%), characterized by persistent lymphopenia, had the lowest cumulative 7-day and 28-day survival rates. After multivariable adjustment, Trajectory 4 was independently associated with an increased risk of 28-day mortality [adjusted HR = 1.76, 95% CI: 1.266-2.446, P = 0.001], ICU mortality (adjusted OR = 1.831, 95% CI: 1.196-2.832, P = 0.006), and in-hospital mortality (adjusted OR = 1.881, 95% CI: 1.298-2.767, P = 0.001) compared to Trajectory 1 (Sustained Recovery), and these associations remained robust across all predefined subgroups. In contrast, no significant association was observed between Trajectory 4 and 7-day mortality after full adjustment for confounders.

conclusionLymphocyte count Trajectory 4 (Persistent Low Level) in initially lymphopenic sepsis patients is independently associated with late (28-day) but not early (7-day) mortality, as well as worse ICU and hospital outcomes. Failure of lymphopenia to recover by days 3-4 may signal a transition to the highest-risk state, suggesting a potential window for immunomodulatory strategies.

Indexed as

LymphocytesLymphopeniaSepsisAgedFemaleHospital MortalityHumansIntensive Care UnitsKaplan-Meier EstimateLymphocyte CountMaleMiddle AgedPrognosisProportional Hazards ModelsRetrospective StudiesRisk Factors

Identifiers

PMID42467654
PMCPMC13378993

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.