Fig. 4
Lymphopenia at 48 h was associated with MODS, high NK dim populations at admission and increased mortality. a Patients who developed MODS (n = 11) were found to have a lower lymphocyte count at 48 h compared to those who did not develop MODS (n = 19). No MODS = 1.3 (1.0–1.7) × 10^9/L, MODS = 0.8 (0.7–1.1) × 10^9/L, p = 0.01. Data are presented as median (IQR) and * denotes p < 0.05 using Mann-Whitney U test. b Patients with lymphopenia at 48 h had a higher percentage of NK dim cells in their circulation at 2 h post injury (n = 31). Lymphocyte count ≥ 1.0 = NK dim 12 % (6–18), < 1.0 = NK dim 17 % (14–25), p < 0.01. Data are presented as median (IQR) and * denotes p < 0.05 using Mann-Whitney U test. c MODS patients had persistent lymphopenia throughout the first 6 days of admission. Daily lymphocyte count was examined in a cohort of ICU patients with an ISS > 15 after blunt trauma (n = 280). All patients had a normal lymphocyte count at admission. Patients who developed MODS had lymphocyte counts well below the normal range from 24 h to 120 h (D6). No MODS: 1.8 (1.6–2.0), 1.2 (1.1–1.2), 1.0 (1.0–1.1), 1.2 (1.1–1.3), 1.2 (1.2–1.3), 1.5 (1.4–1.6), 1.6 (1.4–1.7). MODS: 1.8 (1.4–2.1), 0.9 (0.8–1.0), 0.8 (0.7–0.8), 0.7 (0.7–0.8), 0.6 (0.6–0.7), 0.7 (0.7–0.8), 1.0 (0.9–1.1). Data are presented as mean (95 % CI), dotted line indicates the normal range. Statistical significance was tested using a two-way mixed ANOVA on natural log data (p < 0.001). This was supported by testing for simple main effects using a general linear model univariate analysis at each time point (2 h: p = 0.21, 24 h–144 h: p < 0.001, denoted by*). Data are presented in order 2 h–144 h: F (1278) = 1.65, 22.91, 30.90, 92.59, 202.84, 196.43, 48.74 and η2 = < 0.01, 0.08, 0.10, 0.25, 0.42, 0.41, 0.15. d Severe lymphopenia at 48 h was associated with a high mortality rate. Patients with a lymphocyte count ≤ 0.5 × 109/L had a 45 % mortality rate compared with 6 % in those with a count > 0.5 × 109/L, p < 0.001 using the Mantel-Cox test (n = 280). MODS multiple organ dysfunction syndrome, NK natural killer