Anergy and the severely ill surgical patient.
Delayed hypersensitivity skin test reaction was evaluated using Multitest CMI, an implement which provides seven standardized antigens in a single application. Eighty-two patients requiring Total Parenteral Nutrition for a variety of conditions were studied. The incidence of anergy was 65%. Seven anergic patients died, but there were no deaths in the reactive group, this difference being significant (P = 0.04). There was a significant association of anergy with carcinoma (P = 0.007) and anergic patients with carcinoma had a significantly greater risk of dying than reactive patients without carcinoma (P = 0.038). Anergic patients also had significantly lower nutritional parameters of serum albumin (P = 0.04), transferrin (P less than 0.001), absolute lymphocyte count (P = 0.009) and mid-arm muscle circumference (P = 0.02) compared to the reactive group.
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed; D007108:Immune Tolerance; D007239:Infections / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000276:immunology; D009748:Nutrition Disorders / Q000276:immunology; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications / Q000276:immunology* / Q000401:mortality; D012882:Skin Tests