TY - JOUR

T1 - Incidental lymphopenia and mortality

T2 - a prospective cohort study

AU - Warny, Marie

AU - Helby, Jens

AU - Nordestgaard, Børge Grønne

AU - Birgens, Henrik

AU - Bojesen, Stig Egil

N1 - © 2020 Joule Inc. or its licensors.

PY - 2020/1/13

Y1 - 2020/1/13

N2 - BACKGROUND: It is unknown if incidental lymphopenia detected in the general population is associated with higher all-cause and cause-specific mortality. We aimed to identify the associations between lymphopenia and all-cause and cause specific mortality.METHODS: In a prospective cohort study, we examined and followed participants enrolled in the Copenhagen General Population Study between November 2003 and April 2015. In our analysis, we modelled risks using Cox proportional hazards regression for 3 groups: participants with a lymphocyte count below the 2.5th percentile; those with a lymphocyte count at or between the 2.5th and 97.5th percentiles (reference category); and those with a lymphocyte count above the 97.5th percentile.RESULTS: The cohort included 108 135 participants with a median age of 68 years. During a median follow-up of 9 (interquartile range [IQR] 0-14) years, 10 372 participants died. We found that participants with lymphopenia (lymphocyte count < 1.1 × 109/L) compared with those with a lymphocyte count in the reference range (1.1-3.7 × 109/L) had higher mortality with multivariable adjusted hazard ratios (HRs) of 1.63 (95% confidence interval [CI] 1.51-1.76) for all causes, 1.67 (95% CI 1.42-1.97) for nonhematologic cancers, 2.79 (95% CI 1.82-4.28) for hematologic cancers, 1.88 (95% CI 1.61-2.20) for cardiovascular diseases, 1.88 (95% CI 1.55-2.29) for respiratory diseases, 1.86 (95% CI 1.53-2.25) for infectious diseases, and 1.50 (95% CI 1.19-1.88) for other causes. For all-cause mortality, the highest absolute 2-year risks of death were observed in women (61%) and men (75%) who smoked and were aged 80 years or older with lymphocyte counts less than 0.5 × 109/L. Participants with a lymphocyte count higher than the reference category had increased mortality (adjusted HR 1.17, 95% CI 1.04-1.31).INTERPRETATION: We found that lymphopenia was associated with an increased risk of all-cause and cause-specific mortality.

AB - BACKGROUND: It is unknown if incidental lymphopenia detected in the general population is associated with higher all-cause and cause-specific mortality. We aimed to identify the associations between lymphopenia and all-cause and cause specific mortality.METHODS: In a prospective cohort study, we examined and followed participants enrolled in the Copenhagen General Population Study between November 2003 and April 2015. In our analysis, we modelled risks using Cox proportional hazards regression for 3 groups: participants with a lymphocyte count below the 2.5th percentile; those with a lymphocyte count at or between the 2.5th and 97.5th percentiles (reference category); and those with a lymphocyte count above the 97.5th percentile.RESULTS: The cohort included 108 135 participants with a median age of 68 years. During a median follow-up of 9 (interquartile range [IQR] 0-14) years, 10 372 participants died. We found that participants with lymphopenia (lymphocyte count < 1.1 × 109/L) compared with those with a lymphocyte count in the reference range (1.1-3.7 × 109/L) had higher mortality with multivariable adjusted hazard ratios (HRs) of 1.63 (95% confidence interval [CI] 1.51-1.76) for all causes, 1.67 (95% CI 1.42-1.97) for nonhematologic cancers, 2.79 (95% CI 1.82-4.28) for hematologic cancers, 1.88 (95% CI 1.61-2.20) for cardiovascular diseases, 1.88 (95% CI 1.55-2.29) for respiratory diseases, 1.86 (95% CI 1.53-2.25) for infectious diseases, and 1.50 (95% CI 1.19-1.88) for other causes. For all-cause mortality, the highest absolute 2-year risks of death were observed in women (61%) and men (75%) who smoked and were aged 80 years or older with lymphocyte counts less than 0.5 × 109/L. Participants with a lymphocyte count higher than the reference category had increased mortality (adjusted HR 1.17, 95% CI 1.04-1.31).INTERPRETATION: We found that lymphopenia was associated with an increased risk of all-cause and cause-specific mortality.

KW - Aged

KW - Cardiovascular Diseases/mortality

KW - Cause of Death

KW - Communicable Diseases/mortality

KW - Denmark/epidemiology

KW - Female

KW - Humans

KW - Incidental Findings

KW - Lymphopenia/mortality

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Neoplasms/mortality

KW - Proportional Hazards Models

KW - Prospective Studies

KW - Respiratory Tract Diseases/mortality

KW - Risk Factors

KW - Time Factors

U2 - 10.1503/cmaj.191024

DO - 10.1503/cmaj.191024

M3 - Journal article

C2 - 31932337

VL - 192

SP - E25-E33

JO - C M A J

JF - C M A J

SN - 0008-4409

IS - 2

ER -