The Association Between Absolute Lymphocyte Count and Long-Term Mortality in Critically Ill Medical Patients: Propensity Score-Based Analyses.

Objective: Absolute lymphocyte count (ALC) has been implicated with short-term outcomes in a number of diseases, and we aimed to investigate the association between week-one ALC and long-term mortality in patients who were admitted to the medical intensive care units (ICUs). Methods: We enrolled patients who were admitted to the medical ICUs at the Taichung Veterans General Hospital, a referral centre located in central Taiwan, between 2015 and 2020 to conduct this retrospective cohort study. The outcome of interest was long-term all-cause mortality, and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to determine the association. Furthermore, we employed propensity score-matching (PSM) and weighting techniques, consisting of inverse probability of treatment weighting (IPTW) and covariate balancing propensity score (CBPS), to confirm the association between ALC and mortality. Results: A total of 5722 critically ill patients were enrolled, and the one-year mortality was 44.8%. The non-survivor group had a lower ALC (1549, 1027-2388 vs 1948, 1373-2743 counts/µL, p<0.01) compared with those in the survivor group. Cox regression showed that low ALC was independently associated with mortality (adjHR 1.091, 95% CI 1.050-1.134). Propensity score-based analyses demonstrated the robust association, with adjHRs in the original, PSM, IPTW, and CBPS populations of 1.327 (95% CI 1.224-1.438), 1.301 (95% CI 1.188-1.424), 1.292 (95% CI 1.186-1.407), and 1.297 (95% CI 1.191-1.412), respectively. Sensitivity analyses further showed that the association between low ALC and mortality existed in a dose-response manner. Conclusion: We found that low ALC was associated with long-term mortality in critically ill patients; further studies are warranted to validate and translate these findings into clinical utility.

After-school nutrition education programme improves eating behaviour in economically disadvantaged adolescents.

OBJECTIVE: To investigate whether an after-school nutrition education (ASNE) programme can improve the nutrition knowledge and healthy eating behaviour of adolescents from economically disadvantaged families. DESIGN: One-group pretest and posttest design. Nutrition knowledge and dietary intake were collected using a questionnaire, and anthropometric measurements were measured before and after the intervention. Nine components of healthy eating behaviour were assessed with reference to the Dietary Guideline of Taiwan. Pretest and posttest differences were analysed using generalised estimating equations. SETTING: Three after-school programmes in central and southern Taiwan. The ASNE programme comprised three monthly 1-h sessions (20-30-min lecture and 30-40-min interaction). PARTICIPANTS: A total of 153 adolescents aged 10-15 years from economically disadvantaged families (seventy-eight elementary students and seventy-five junior high school students). RESULTS: Elementary and junior high school students' nutrition knowledge scores (range 0-6) increased by 0·28 (+ 5·7 %, P = 0·02) and 0·30 points (+ 6·18 %, P = 0·02), respectively, but their fruit intake decreased by 0·36 serving/d (-22·9 %, P = 0·02) and 0·29 serving/d (-18·9 %, P = 0·03), respectively. Junior high school students' mean snacking frequency and fried food intake dropped to 0·75 d/week (-21·3 %, P = 0·008) and 0·10 serving/d (-28·8 %, P = 0·01), respectively. CONCLUSIONS: Short-term ASNE programmes can increase nutrition knowledge and reduce snacking frequency and fried food intake despite a decrease in fruit intake among adolescents from economically disadvantaged families.