Abstract 2457: Atrial Fibrillation is Associated with Severe Sleep Disordered Breathing TIA and Stroke Patients

Background and Purpose Sleep disordered breathing (SBD) was reported to be a risk factor for cerebrovascular disease. We investigated the frequency of SDB in Japanese patients with acute transient ischemic attack (TIA) and stroke and the factors associated with severe SDB in Japan. Methods Between May 2010 and April 2011, we prospectively enrolled TIA and stroke patients within 24 hours of onset and performed sleep study up to 7 days after admission. SBD was defined as respiratory disturbance index (RDI: apnea or hypopnea event per hour) ≥5. Patients were divided into 2 groups according to the RDI value as follows: ≥30(severe) and <30(none or non-severe). We demonstrated the frequency of SDB and the factors associated with severe SDB were investigated by multivariate regression analysis. Results A total of 150 patients (92 males; mean age, 72.8 years) were enrolled in this study; 28 had TIA and 122 had stroke. The mean time from admission to sleep study was 4 days. Mean RDI was 22.2±17.6. SDB was observed in 126(84%) patients. Frequencies of SDB were as follows: 21(75%) patients in TIA, 105(86%) in stroke [8/10(80%) in large artery atherosclerosis, 14/14(100%) in small vessel occlusion, 37/41(90%) in cardioembolism, 46/57(81%) in other cause of stroke/undetermined]. Severe SDB was observed in 44 (29%) patients; 21% in TIA and 31% in stroke. Frequencies of male (75% for the severe SDB group vs. 56% for the non-severe SDB group, p=0.027), atrial fibrillation (39% vs. 23%, p=0.045), body mass index (23.8±3.8 vs. 22.3±3.8, p=0.043), and neck circumference (37.8±4.3 vs. 35.8±4.2, p=0.012) were significantly higher in the severe SDB than in the non-severe SDB. Metabolic syndrome (36% vs. 21%, p=0.057) and waist circumference (88.9±9.8 vs. 85.5±9.3, p=0.080) showed a tendency toward higher in the severe SDB group than in the non-severe SDB group. There were no significant differences in age, prior stroke, vascular risk factors, Glasgow Coma Scale, and NIHSS score on admission. On multivariate regression analysis, atrial fibrillation (odds ratio, 2.5; 95% confidence interval, 1.079-5.836, p=0.0326) was found to be independently associated with severe SDB. Conclusions Most Japanese patients with acute TIA and stroke had SDB, and the presence of atrial fibrillation was associated with severe SDB.

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Abstract TP208: Medullary Infarction is Associated with Severe Sleep Disordered Breathing

Stroke ◽

10.1161/str.44.suppl_1.atp208 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Shuichi Fujii ◽

Kensaku Shibazaki ◽

Kenichiro Sakai ◽

Junya Aoki ◽

Junichi Uemura ◽

...

Keyword(s):

Ischemic Stroke ◽

Multivariate Regression ◽

Sleep Disordered Breathing ◽

Multivariate Regression Analysis ◽

Stroke Patients ◽

Sleep Study ◽

Respiratory Disturbance ◽

The Relationship ◽

Medullary Infarction ◽

Disordered Breathing

Background and Purpose: A relationship between presence or severity of sleep disordered breathing (SDB) and site of lesion in ischemic stroke patients has been unclear. Our aim of the present study was to investigate the relationship between presence or severity of SDB and site of ischemic lesions in stroke patients. Subjects and Methods: Between April 2010 and March 2012, consecutive ischemic stroke patients within 24 hours of onset were prospectively enrolled. Ischemic lesions were identified by MRI on admission. Patient underwent sleep study to evaluate the presence and severity of SDB within 7 days after admission. SDB was defined as a respiratory disturbance index (RDI; apnea/hypopnea events per hour) ≥ 5, and severe SDB was defined as a RDI ≥ 40. We investigated the relationship between presence or severity of SDB and clinical characteristics including site of ischemic lesions. Results: A total of 214 patients (mean age 71.3, male 132) were enrolled. Supratentrial lesion was observed in 166 (77.6%) patients and right side lesion in 101 (47.2%) patients. Sites of ischemic lesions were as follows; cortex (n=11), subcortex (n=35), cortex plus subcortex (n=75), basal ganglia (n=57), thalamus (n=13), midbrain (n=3), pons (n=27), medulla (n=11), and cerebellum (n=22). Sleep study was performed at 4 days (median). The median RDI (IQR) was 20 (10-34). SDB patients were found in 187 (87%) patients. There were no significant differences in frequency of each site of lesions between SDB and non-SDB patients. Severe SDB was observed in 42 (19.6%) patients. Age (75 (70-83) vs. 72 (64-78), p=0.047), NIHSS score on admission (3 (1-10) vs. 7 (2-12), p=0.047), the frequency of atrial fibrillation (41% vs. 22%, p=0.012) and medullary lesions (12% vs. 4%, p=0.027) were significantly higher in severe SDB patients than non-severe SDB. Multivariate regression analysis demonstrated that medullary lesions (OR 5.5, 95%CI 1.41-21.8, p=0.014) was independently associated with severe SDB. Conclusions: Medullary lesion in stroke patients should be associated with severe SDB.

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Patient-Related Risk Factors Associated With Surgical Site Complications After Elective Hand Surgery

Hand ◽

10.1177/1558944720944260 ◽

2020 ◽

pp. 155894472094426

Author(s):

Tyler Youngman ◽

Michael Del Core ◽

Timothy Benage ◽

Daniel Koehler ◽

Douglas Sammer ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Surgical Complications ◽

Multivariate Regression ◽

Univariate Analysis ◽

Hand Surgery ◽

Multivariate Regression Analysis ◽

Class Iii ◽

Factors Associated ◽

Surgical Site Complications

Background: The purpose of this study was to identify independent risk factors associated with an increased rate of surgical site complications after elective hand surgery. Methods: This study is a retrospective review of all patients who underwent elective hand, wrist, forearm, and elbow surgery over a 10-year period at a single institution. Electronic medical records were reviewed, and information regarding patient demographics, past medical and social history, perioperative laboratory values, procedures performed, and surgical complications was collected. Surgical site complications included surgical site infections, seromas or hematomas, and delayed wound healing or wound dehiscence. A univariate analysis was then performed to identify potential risk factors, which were then included in a multivariate regression analysis. Results: A total of 3261 patients who underwent elective hand surgery and met the above inclusion and exclusion criteria were included in this study. The mean age was 57 years, with 65% female and 35% male patients. The overall surgical complication rate was 2.2%. Univariate analysis of patient factors identified male sex; number of procedures >1; history of drug, alcohol, or smoking use; American Society of Anesthesiologists (ASA) class III and IV; and serum albumin <3.5 mg/dL to be significantly associated with complications. However, multivariate regression analysis identified that only ASA class III and IV (odds ratio = 3.27) was significantly associated with surgical complications. Conclusions: Patients classified as ASA class III or IV were identified to be at a significantly increased risk of complications following elective hand surgery. Health factors which triage patients into these 2 groups may represent potentially modifiable factors to mitigate perioperative risk in the elective hand surgery population.

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Disparities in colorectal cancer (CRC) screening in an underserved population

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.6569 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 6569-6569

Author(s):

A. Y. Lin ◽

N. Kouzminova ◽

T. Lu

Keyword(s):

Regression Analysis ◽

Inner City ◽

Survival Benefit ◽

Multivariate Regression ◽

Multivariate Regression Analysis ◽

Screening Tests ◽

Underserved Population ◽

Insurance Status ◽

Crc Screening ◽

Factors Associated

6569 Background: CRC is a common, potentially lethal, yet preventable disease. Screening tests for CRC are known to reduce the rate of death by detecting early cancer. To evaluate factors associated with the practice and impact of CRC screening, we reviewed a decade of CRC patients treated at an inner-city hospital. Methods: Under an IRB-approved protocol, data, including demographics, stage at diagnosis, utilization of screening tests, and insurance status, were obtained from CRC patients, at age 50 or above at diagnosis, treated between 1994 and 2004 at Santa Clara Valley Medical Center, a public hospital in the Silicon Valley. Chi-square test and multivariate regression analysis were used to evaluate factors associated with screening and its outcome. Results: We identified 331 cases of CRC patients who met the study criteria, with 50.5% (167) male and 49.5% (164) female patients. By ethnicity 36.6% (121) of the patients were Asian, 3.6% (12) Black, 22.8% (72) Hispanic, 37.8% (125) white, and 0.3% (1) other ethnicity. Only 5.7% (19) of the patients had been diagnosed by a screening colonoscopy, and 5.4% (18) of the patients had screening fecal occult blood test (FOBT). As a result, 9.4% (31) patients were diagnosed after either a positive colonoscopy or FOBT. Their stage distribution is presented in the table below. There was no association between the screening practice and gender, age, race or insurance status in this cohort. CRC diagnosed by screening test was significantly associated with survival benefit (p<0.01). Multivariate regression analysis revealed that survival was significantly associated with stage (p<0.05) and Hispanic race (p<0.01); but not screening test or insurance status. Conclusions: In this underserved population, even with a low rate of screening tests, screening for CRC is associated with earlier stage of CRC presentation which has been linked with survival benefit. Further studies are needed to identify barriers to CRC screening in this inner-city population. [Table: see text] No significant financial relationships to disclose.

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Prolonged SARS-CoV-2 Viral Shedding in Patients with COVID-19 was Associated with Delayed Initiation of Arbidol Treatment: a retrospective cohort study

10.1101/2020.06.09.20076646 ◽

2020 ◽

Cited By ~ 3

Author(s):

Yaya Zhou ◽

Xinliang He ◽

Jianchu Zhang ◽

Yu’e Xue ◽

Mengyuan Liang ◽

...

Keyword(s):

Regression Analysis ◽

Multivariate Regression ◽

Multivariate Regression Analysis ◽

Virus Shedding ◽

Illness Onset ◽

Factors Associated ◽

Viral Shedding ◽

Union Hospital ◽

Delayed Initiation ◽

The Impact

AbstractObjectivesEvaluate the risk factors of prolonged SARS-CoV-2 virus shedding and the impact of arbidol treatment on SARS-CoV-2 virus shedding.MethodsData were retrospective collected from adults hospitalized with COVID-19 in Wuhan Union Hospital. We described the clinical features and SARS-CoV-2 RNA shedding of patients with COVID-19 and evaluated factors associated with prolonged virus shedding by multivariate regression analysis.ResultsAmong 238 patients, the median age was 55.5 years, 57.1% were female, 92.9% (221/238) used arbidol, 58.4% (139/238) used arbidol combination with interferon. The median time from illness onset to start arbidol was 8 days (IQR, 5-14 days) and the median duration of SARS-CoV-2 virus shedding was 23 days (IQR, 17.8–30 days). SARS-CoV-2 RNA clearance was significantly delayed in patients who received arbidol >7 days after illness onset, compared with those in whom arbidol treatment was started≤7 days after illness onset (HR, 1.738 [95% CI, 1.339–2.257], P < .001). Multivariate regression analysis revealed that prolonged viral shedding was significantly associated with initiation arbidol more than seven days after symptom onset (OR 2.078, 95% CI [1.114-3.876], P .004), more than 7 days from onset of symptoms to first medical visitation (OR 3.321, 95% CI[1.559-7.073], P .002), illness onset before Jan.31, 2020 (OR 3.223, 95% CI[1.450-7.163], P .021). Arbidol combination with interferon was also significantly associated with shorter virus shedding (OR .402, 95% CI[.206-.787], P .008).ConclusionsEarly initiation of arbidol and arbidol combination with interferon as well as consulting doctor timely after illness onset were helpful for SARS-CoV-2 clearance.

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Antibody Response to Canine Adenovirus-2 Virus Vaccination in Healthy Adult Dogs

Viruses ◽

10.3390/v12101198 ◽

2020 ◽

Vol 12 (10) ◽

pp. 1198

Author(s):

Michèle Bergmann ◽

Monika Freisl ◽

Yury Zablotski ◽

Stephanie Speck ◽

Uwe Truyen ◽

...

Keyword(s):

Regression Analysis ◽

Antibody Response ◽

Urban Areas ◽

Multivariate Regression ◽

Healthy Adult ◽

Multivariate Regression Analysis ◽

Exact Test ◽

Virus Vaccination ◽

Factors Associated ◽

Vaccination Response

Background: Re-vaccination against canine adenovirus (CAV) is performed in ≤3-year-intervals but their necessity is unknown. The study determined anti-CAV antibodies within 28 days of re-vaccination and factors associated with the absence of antibodies and vaccination response. Methods: Ninety-seven healthy adult dogs (last vaccination ≥12 months) were re-vaccinated with a modified live CAV-2 vaccine. Anti-CAV antibodies were measured before vaccination (day 0), and after re-vaccination (day 7, 28) by virus neutralization. A ≥4-fold titer increase was defined as vaccination response. Fisher’s exact test and multivariate regression analysis were performed to determine factors associated with the absence of antibodies and vaccination response. Results: Totally, 87% of dogs (90/97; 95% CI: 85.61–96.70) had anti-CAV antibodies (≥10) before re-vaccination. Vaccination response was observed in 6% of dogs (6/97; 95% CI: 2.60–13.11). Time since last vaccination (>3–5 years, OR = 9.375, p = 0.020; >5 years, OR= 25.000, p = 0.006) was associated with a lack of antibodies. Dogs from urban areas were more likely to respond to vaccination (p = 0.037). Conclusion: Many dogs had anti-CAV pre-vaccination antibodies, even those with an incomplete vaccination series. Most dogs did not respond to re-vaccination. Based on this study, dogs should be re-vaccinated every 3 years or antibodies should be determined.

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Risk factors for progression of solitary plasmacytoma of bone to multiple myeloma in the spine: A population-based study

10.21203/rs.2.17500/v2 ◽

2020 ◽

Author(s):

Lin Xie ◽

Hongli Wang ◽

Jianyuan Jiang ◽

Chaojun Zheng

Keyword(s):

Risk Factors ◽

Multiple Myeloma ◽

Regression Analysis ◽

Multivariate Regression ◽

Multivariate Regression Analysis ◽

Population Based ◽

Solitary Plasmacytoma ◽

Aged Patients ◽

Factors Associated ◽

Risk Of Progression

Abstract Background: Spine SBP is a primary spinal malignant tumor. Risk factors associated with progression of solitary plasmacytoma of bone (SBP) to multiple myeloma in spine remains unknown. This study therefore aimed to identify the risk factors associated with progression of solitary plasmacytoma of bone (SBP) to multiple myeloma in the spine.Methods: Data of 1543 patients diagnosed with spine SBP between 1992 and 2013 was obtained from the Surveillance, Epidemiology, and End Results (SEER) database for analysis. Risk factors associated with progression of SBP to multiple myeloma (MM) were then identified using univariate and multivariate regression analysis methods.Results: Out of the 1543 patients diagnosed with spine SBP, 659 of them progressed to MM. The overall rate of progression to MM was 42.51%. Univariate and multivariate regression analysis revealed that age, race, gender and chemotherapy were independent risk factors associated with SBP progression to MM.Conclusion: Old aged patients, patients belonging to the white race, female patients and those undergoing chemotherapy were identified to be at a high risk of progression to MM. This information will assist clinicians in evaluating patients’ risk of SBP progression to MM at the point of diagnosis and advise them accordingly.

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Medical Factors Associated With Fracture Nonunion: A Retrospective Study

10.21203/rs.3.rs-1043433/v1 ◽

2021 ◽

Author(s):

Rongrong Wang ◽

Dawei Wang ◽

Zheng Chen ◽

Jingyu Ma ◽

Lili Wang ◽

...

Keyword(s):

Regression Analysis ◽

High Risk ◽

Multivariate Regression ◽

Multivariate Regression Analysis ◽

Injury Mechanism ◽

Fibrinogen Concentration ◽

Distribution Width ◽

Factors Associated ◽

Asa Classification ◽

Femur Fractures

Abstract Background: Nonunion is one of the medical conditions challenging the trauma specialists. Timely identification of people at high risk of nonunion is important to improve the prognosis of patients.Methods: We retrospectively analyzed the demographic and laboratory hematological characteristics of 338 patients with either clavicle or femoral fractures treated with ORIF in Shandong Provincial Hospital affiliated to Shandong University from January 2010 to May 2019. Descriptive statistics, univariate regression analysis, and multivariate regression analysis were conducted to confirm the independent factors associated with nonunion after ORIF.Results: The overall nonunion rate among the patients investigated in this study was ~6.8%, while the nonunion rates were 5.6% and 10.3% in clavicle and the femur fractures, respectively. Results of the univariate logistic regression analysis showed that the serum fibrinogen concentration (FIB), the hemoglobin count (HGB), the lymphocyte absolute value (LYMPH), the coefficient of variation of red blood cell distribution width (RDW-CV), the American Society of Anesthesiologists (ASA) classification, and the mechanism of injury were related to the occurrence of nonunion (p < 0.05). Results of the multivariate regression analysis showed that FIB (OR = 1.64, 95% CI of 1.14 to 2.36, p < 0.01), LYMPH (OR = 0.34, 95% CI of 0.15 to 0.77, p < 0.01), ASA classification (OR = 3.52, 95% CI of 1.20 to 10.31, p = 0.02), and injury mechanism (OR=3.13, 95% CI of 1.20 to 8.21, p = 0.02) were independently associated with the occurrence of nonunion.Conclusions: Our study has revealed that FIB, LYMPH, ASA classification, and injury mechanism are independently related to the occurrence of nonunion after ORIF, providing important guidance for clinicians to identify patients with high risk of nonunion in time, ultimately improving the prognosis and quality of life of patients.

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Left Atrial Phasic Function in Patients with Hypertension and Recurrent Atrial Fibrillation: Gender Differences of the Relationship with Diastolic Dysfunction and Central Aortic Pressure

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2019-15-5-622-633 ◽

2019 ◽

Vol 15 (5) ◽

pp. 622-633

Author(s):

E. V. Kokhan ◽

E. M. Ozova ◽

V. A. Romanova ◽

G. K. Kiyakbaev ◽

Zh. D. Kobalava

Keyword(s):

Atrial Fibrillation ◽

Regression Analysis ◽

Ejection Fraction ◽

Left Atrial ◽

Multivariate Regression ◽

Multivariate Regression Analysis ◽

Aortic Pressure ◽

Men And Women ◽

Central Aortic Pressure ◽

Recurrent Atrial Fibrillation

Aim. To evaluate gender-related differences of left atrial (LA) phasic function and structural remodeling in conjunction with the parameters of left ventricular (LV) diastolic dysfunction and central aortic pressure in patients with hypertension and recurrent atrial fibrillation (AF).Material and methods. The comparative study included 30 men and 37 women with non-valvular AF, hypertension and LV hypertrophy. Conventional echocardiographic measures were extended with LA measures, including its volume in three phases, LAemptying fraction (LAEF), passive and active ejection fraction. The parameters of central aortic pressure were estimated by applanation tonometry method.Results. No difference was observed between LA and LV structural parameters in men and women. However, in women LAEF (39 [28;50] vs 50 [42;55]%; p=0.02) and E/E’(9.7 [7.8;12] vs 7.1 [5.6;8.6]; p=0.001) were worse than in men. Active LA ejection fraction was higher in women (31 [21;42] vs 24 [19;31]%; p=0.04), whereas passive one – in men (12 [10;14] vs 33 [23;38]%; p<0.001), respectively. Men and women had comparable heart rate (HR), central and peripheral systolic and diastolic pressure, pulse wave velocity (PWV), but women had higher augmentation index (AI) values [33 [28;39] vs 23 [21;28]%; p<0.001], even adjusted by HR (AI 75) (34 [27;39] vs 26 [20;29]%; p<0.001). Only in men PWV weakly correlated with AI 75 (r=0.44; p=0.02 versus r=-0.11; p=0.51, respectively for men and women; intergroup differences: z=2.26; p=0.012). In a multivariate regression analysis in men LAEF was significantly associated with height, weight, E’, E/E’ and glomerular filtration rate (GFR), whereas in women – with E’ and AI 75.Conclusion. Patients of different genders with recurrent AF and hypertension have comparable LA structuralremodeling. However, women characterized by a more pronounced decrease in LAEF and impaired LV diastolic function than men. In women as distinct from men LV filling is predominantly due to LA systole. In a multivariate regression analysis in men LAEF was significantly associated with height, weight, E’, E/E’ and GFR, whereas in women – with E’ and AI 75.

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Abstract 11254: Association of Sleep Disordered Breathing and Sleep Architecture With Atrial Fibrillation: The MESA Study

Circulation ◽

10.1161/circ.130.suppl_2.11254 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Younghoon Kwon ◽

Sina A Gharib ◽

Mary Lou Biggs ◽

David R Jacobs ◽

Alvaro Alonso ◽

...

Keyword(s):

Atrial Fibrillation ◽

Sleep Disordered Breathing ◽

Slow Wave Sleep ◽

Cross Sectional Study ◽

Sleep Architecture ◽

Apnea Hypopnea Index ◽

Cvd Risk ◽

Cross Sectional ◽

Sleep Study ◽

Disordered Breathing

Background: Sleep disordered breathing (SDB) has been associated with nocturnal atrial fibrillation (AF). However, the association of SDB and other important sleep characteristics with prevalent AF (beyond nocturnal AF) is unclear. We explored the cross-sectional association of SDB and other objectively measured sleep characteristics with AF. Methods: Prevalence of AF was examined among MESA (Multi-Ethnic Study of Atherosclerosis) study participants who underwent polysomnography (PSG) (n=2048) (MESA Sleep Study). Presence or a history of AF was determined if AF or atrial flutter was identified by at least one of the following measures: (i) 12-lead ECG during study examination; (ii) PSG; (iii) ICD-9 codes from hospital discharge diagnosis; (IV) inpatient and outpatient Medicare claims data. Results: Overall prevalence of AF was 4.9 % (n=100). Prevalence of AF was significantly higher at 6.7% in subjects with moderate to severe SDB (n = 691, apnea hypopnea index (AHI) ≥15/h) compared with a prevalence of 4.0% in participants without SDB (n = 707, AHI < 5/h) (p=0.02). After accounting for demographics, body habitus, cardiovascular disease (CVD) risk factors and prevalent CVD, participants with higher values of AHI were more likely to have AF, although the result was not statistically significant (OR: 1.22 [0.99-1.49] per SD [17/hr], p = 0.06). Exploratory analyses of the association of sleep architecture with AF using the same model found significantly lower odds of AF associated with longer duration of slow wave sleep (SWS) (OR: 0.66 [0.5-0.89] per SD [34 min], p = 0.01). Results from a multivariable model that included 3 key sleep characteristics (AHI, SWS time and arousal index (AI)) suggested that all were independently associated with AF (AHI: OR 1.45 [1.13-1.87] per SD, p = 0.004; SWS time: OR 0.65 [0.49-0.87] per SD, p = 0.004; AI: OR 0.65 [0.50-0.86] per SD (12/hr), p = 0.002). Conclusion: In a cross-sectional study of a large multi-ethnic population, the prevalence of AF was associated with more severe SDB, shorter SWS time, and lower AI. This finding highlights sleep architecture’s implication, potentially via autonomic balance, in the association between sleep and AF.

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Severe lymphopenia as a prognostic factor in rectal cancer patients receiving adjuvant chemoradiotherapy: a retrospective study

10.21203/rs.2.11420/v1 ◽

2019 ◽

Author(s):

Minjun Zhang ◽

Guangxian You ◽

Hongen Xu ◽

Tao Song ◽

Haibo Zhang ◽

...

Keyword(s):

Rectal Cancer ◽

Regression Analysis ◽

Multivariate Regression ◽

Locally Advanced ◽

Advanced Rectal Cancer ◽

Multivariate Regression Analysis ◽

Locally Advanced Rectal Cancer ◽

Adjuvant Chemoradiotherapy ◽

Factors Associated ◽

The Relationship

Abstract Objectives The relationship between total lymphocyte counts (TLCs) and survival is not well documented in rectal cancer. This study aimed to investigate the association between TLCs and disease-free survival (DFS) and identify factors associated with lymphopenia in locally advanced rectal cancer patients receiving chemoradiotherapy. Methods Thirty-six patients with locally advanced rectal cancer were retrospectively analyzed. TLCs were evaluated before surgery (pre-S), before radiotherapy (pre-RT), and during concurrent chemoradiotherapy (CCRT). The relationship between TLCs and DFS was analyzed by univariate and multivariate analysis. Potential clinical factors associated with lymphopenia were also evaluated. Results Median TLC declined significantly during radiotherapy. Severe lymphopenia during CCRT was significantly associated with poorer DFS on Kaplan-Meier analysis (p=0.01), univariate regression analysis (p=0.036), and multivariate regression analysis (p=0.038). Pre-S TLCs (p=0.009) and pre-RT TLCs (p=0.042) were significantly associated with severe lymphopenia on univariate regression analysis; however, only pre-S TLCs (p=0.026) were significantly associated with severe lymphopenia on multivariate regression analysis. Conclusions Severe lymphopenia was a predictor of poorer DFS in patients with locally advanced rectal cancer receiving adjuvant chemoradiotherapy. Pre-S TLCs were predictors of severe lymphopenia. Further study is warranted to reduce the rate of severe lymphopenia.

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