scholarly journals Evaluation of eosinophil count and neutrophil-lymphocyte count ratio versus C-reactive protein levels in patients with sepsis

2017 ◽  
Vol 5 (11) ◽  
pp. 4754
Author(s):  
Rahul Khajuria ◽  
Vinu Jamwal ◽  
Anil K. Gupta ◽  
Abhinav Gupta
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Critically Ill Patients ◽  
Eosinophil Count ◽  
Lymphocyte Count ◽  
Sepsis Group ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Count Ratio

Background: One major problem encountered in the intensive care unit is differentiating the inflammatory response from an infective process. Clinical and standard laboratory tests are not very helpful because most critically ill patients develop some degree of inflammatory response, whether or not they have sepsis. Numerous biomarkers have been evaluated to predict mortality in critically ill patients, although none have proved entirely useful. Objective of the study was to evaluate eosinophil count and neutrophil-lymphocyte count ratio with C-reactive protein levels in patients with sepsis.Methods: 71 patients >18 years of age of either sex with a diagnosis of sepsis were enrolled in this one-year observational study. Patients were classified according to the criteria of the American College of Chest Physicians/Society of Critical Care Medicine into sepsis group (n=50) and no sepsis group (n=21). Sepsis group were further divided into subgroups: sepsis (n=19), severe sepsis (n=16) and septic shock (n=15). Absolute eosinophil cell, neutrophil and lymphocyte counts for first 4 consecutive days and then on alternate days up to one week were also noted down. C-reactive protein levels on day 3 were also noted down.Results: In the sepsis group, mean eosinophil count was significantly (p<0.0001) low, mean neutrophil/lymphocyte count ratio was significantly (p<0.0001) high, mean CRP count was significantly (p=0.019) more as compared to that of no sepsis group. Among 16 mortalities, significant (p<0.05) decrease was noted in mean eosinophil count from day 3 onwards in patients of sepsis and septic shock subgroups. Mean N/L ratio showed no significant difference in patients of sepsis, severe sepsis or septic shock. Mean CRP count showed significant (p<0.05) increase in severe sepsis patients and mean Apache II score showed significant (p<0.05) deterioration in patients of septic shock.Conclusions: Neutrophil/lymphocyte count ratio (NLCR) and absolute eosinophil count (AEC) came out as better independent biomarker of sepsis in critically ill patients with infection admitted in intensive care unit. Diagnostic performance was better in these two diagnostic markers as compared to CRP marker. NLCR presented with sensitivity of 89.58%, AEC with 82.35% and CRP with 80.77%. Outcomes of NLCR and AEC were quick, easy and economical in establishing diagnosis of sepsis.

scholarly journals A novel procalcitonin-based score for detecting sepsis among critically ill patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245748
Author(s):  
Tung-Lin Tsui ◽  
Ya-Ting Huang ◽  
Wei-Chih Kan ◽  
Mao-Sheng Huang ◽  
Min-Yu Lai ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Validation Cohort ◽  
Multivariate Logistic Regression Analysis ◽  
Sepsis Group ◽  
C Reactive Protein ◽  
Multivariate Logistic Regression ◽  
Reactive Protein

Background Procalcitonin (PCT) has been widely investigated as an infection biomarker. The study aimed to prove that serum PCT, combining with other relevant variables, has an even better sepsis-detecting ability in critically ill patients. Methods We conducted a retrospective cohort study in a regional teaching hospital enrolling eligible patients admitted to intensive care units (ICU) between July 1, 2016, and December 31, 2016, and followed them until March 31, 2017. The primary outcome measurement was the occurrence of sepsis. We used multivariate logistic regression analysis to determine the independent factors for sepsis and constructed a novel PCT-based score containing these factors. The area under the receiver operating characteristics curve (AUROC) was applied to evaluate sepsis-detecting abilities. Finally, we validated the score using a validation cohort. Results A total of 258 critically ill patients (70.9±16.3 years; 55.4% man) were enrolled in the derivation cohort and further subgrouped into the sepsis group (n = 115) and the non-sepsis group (n = 143). By using the multivariate logistic regression analysis, we disclosed five independent factors for detecting sepsis, namely, “serum PCT level,” “albumin level” and “neutrophil-lymphocyte ratio” at ICU admission, along with “diabetes mellitus,” and “with vasopressor.” We subsequently constructed a PCT-based score containing the five weighted factors. The PCT-based score performed well in detecting sepsis with the cut-points of 8 points (AUROC 0.80; 95% confidence interval (CI) 0.74–0.85; sensitivity 0.70; specificity 0.76), which was better than PCT alone, C-reactive protein and infection probability score. The findings were confirmed using an independent validation cohort (n = 72, 69.2±16.7 years, 62.5% men) (cut-point: 8 points; AUROC, 0.79; 95% CI 0.69–0.90; sensitivity 0.64; specificity 0.87). Conclusions We proposed a novel PCT-based score that performs better in detecting sepsis than serum PCT levels alone, C-reactive protein, and infection probability score.

scholarly journals Procalcitonin and C-reactive protein levels at admission as predictors of duration of acute brain dysfunction in critically ill patients

Critical Care ◽  
2011 ◽  
Vol 15 (2) ◽  
pp. R78 ◽  
Author(s):  
Stuart McGrane ◽  
Timothy D Girard ◽  
Jennifer L Thompson ◽  
Ayumi K Shintani ◽  
Alison Woodworth ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Brain Dysfunction ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Acute Brain Dysfunction

scholarly journals An Evaluation of Serum Procalcitonin and C-Reactive Protein Levels as Diagnostic and Prognostic Biomarkers of Severe Sepsis

2015 ◽  
Vol 1 (4) ◽  
pp. 147-153 ◽  
Author(s):  
Janos Szederjesi ◽  
Emoke Almasy ◽  
Alexandra Lazar ◽  
Adina Huțanu ◽  
Iudita Badea ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
The Body ◽  
Apache Ii ◽  
Prognostic Biomarkers ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Saps Ii ◽  
Severity Scores ◽  
Saps Ii Score

Abstract Background: Recommendations have been made, following the multicenter Surviving Sepsis Campaign study, to standardize the definition of severe sepsis with reference to several parameters such as haemodynamic stability, acid-base balance, bilirubin, creatinine, International Normalized Ratio (INR), urine output and pulmonary functional value of the ratio between arterial oxigen partial pressure and inspiratory oxigen concentration. Procalcitonin (PCT) is considered to be a gold standard biomarker for the inflammatory response, and recent studies have shown that it may help to discover whether a seriously ill person is developing sepsis. C-reactive protein (CRP) is also used as a marker of inflammation in the body, as its blood levels increase if there is any inflammation in the body. The aim of this study was to evaluate serum procalcitonin and C-reactive protein levels as diagnostic and prognostic biomarkers of severe sepsis. Material and method: Sixty patients, diagnosed as being “septic”, were admitted to the intensive care unit (ICU). Based on laboratory results and clinical findings a diagnosis of “severe sepsis“ was made, and correlated with PCT and CRP values. The APACHE II, SAPS II and SOFA severity scores were calculated, analyzed and correlated with PCT and CRP. Results: Fifty two patients (86.67%) presented with criteria for severe sepsis. Multivariate correlation analysis indicated a significant positive association between procalcitonin and all severity scores (APACHEII p<0.0001, SOFA p<0.0001, SAPS II p<0.0001). CRP proved to be significantly correlated only with the SAPS II score (p=0.0145). Mortality rate was high, with 48 patients (80%) dying. There was no significant correlation between the levels of the PCT and CRP biomarkers and severe sepsis (p=0.2059 for PCT, p=0.6059 for CRP). Conclusions: The procalcitonin levels are highly correlated with the severity scores (APACHE II, SAPS II, SOFA) regularly used in ICUs and therefore can be used for determining the severity of the septic process. Quantitive procalcitonin and C-reactive protein analysis was not shown to be useful in diagnosing severe sepsis. However, PCT and CRP can be used to predict the fatal progression of the septic patient.

scholarly journals Diagnostic accuracy of procalcitonin, neutrophil-lymphocyte count ratio, C-reactive protein, and lactate in patients with suspected bacterial sepsis

PLoS ONE ◽  
2017 ◽  
Vol 12 (7) ◽  
pp. e0181704 ◽  
Author(s):  
Lars Ljungström ◽  
Anna-Karin Pernestig ◽  
Gunnar Jacobsson ◽  
Rune Andersson ◽  
Barbara Usener ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Lymphocyte Count ◽  
Bacterial Sepsis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Count Ratio

scholarly journals Prognostic Value And Daily Trend Of Interleukin-6, Neutrophil CD64 Expression, C-Reactive Protein And Lipopolysaccharide-Binding Protein In Critically Ill Patients: Reliable Predictors Of Outcome Or Not?

2015 ◽  
Vol 34 (4) ◽  
pp. 431-439 ◽  
Author(s):  
Dragan Djordjevic ◽  
Janko Pejovic ◽  
Maja Surbatovic ◽  
Jasna Jevdjic ◽  
Sonja Radakovic ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Interleukin 6 ◽  
Prognostic Value ◽  
C Reactive Protein ◽  
Lipopolysaccharide Binding Protein ◽  
Cd64 Expression ◽  
Reactive Protein ◽  
Lipopolysaccharide Binding

SummaryBackground:Severe sepsis and/or trauma complicated by multiple organ dysfunction syndrome are the leading causes of death in critically ill patients. The aim of this prospective single-centre study was to assess the prognostic value and daily trend of interleukin-6 (IL-6), neutrophil CD64 expression, C-reactive protein (CRP) and lipopolysaccharide-binding protein (LBP) regarding outcome in critically ill patients with severe trauma and/or severe sepsis. Outcome measure was hospital mortality.Methods:One hundred and two critically ill patients admitted to the intensive care unit of a tertiary university hospital were enrolled in this prospective study. Blood samples were collected on admission (day 1), days 2 and 3.Results:CD64 index was 1.6-fold higher on day 1 and 1.78-fold higher on day 2 in non-survivors (p<0.05). The area under the curve (AUC) for the CD64 index on day 1 for outcome was 0.727. At a cut-off level of 2.80 sensitivity was 75% and specificity was 65%. Patients with CD64 index level on day 1 higher than 2.80 had 2.4-fold higher probability of dying. Odds ratio is 2.40; 95% CI 0.60–9.67.Conclusions:CD64 index on day 1 is a fairly good predictor of outcome. AUCs for IL-6, CRP and LBP were < 0.55, suggesting these biomarkers failed to predict outcome.

scholarly journals The prognostic and risk-stratified value of neutrophil–lymphocyte count ratio in Chinese patients with community-acquired pneumonia

2017 ◽  
Vol 15 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Ting Yang ◽  
Chun Wan ◽  
Hao Wang ◽  
Jiangyue Qin ◽  
Lei Chen ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Lymphocyte Count ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Serum Levels ◽  
Community Acquired Pneumonia ◽  
C Reactive Protein ◽  
Pneumonia Severity ◽  
Reactive Protein ◽  
Count Ratio

Community-acquired pneumonia is a common disease associated with high mortality. This retrospective study examined whether the neutrophil–lymphocyte count ratio (NLR), already widely used as an index of inflammation, can be used to predict in-hospital mortality of adults with community-acquired pneumonia. Clinical characteristics, CURB-65 and pneumonia severity index score of pneumonia severity, NLR, serum levels of C-reactive protein and procalcitonin, and in-hospital mortality were analyzed for 318 consecutive adults with community-acquired pneumonia admitted to West China Hospital between July 2012 and December 2013. The ability of NLR and other parameters to predict in-hospital mortality was assessed using receiver operating characteristic (ROC) curves. Results showed that NLR increased with increasing CURB-65 ( P < 0.05) and pneumonia severity index ( P < 0.05), and NLR correlated positively with serum levels of C-reactive protein (r = 0.239, P < 0.05) and procalcitonin (r = 0.211, P < 0.05). The median value of NLR was significantly higher among patients who died in hospital (11.96) than among those who were alive at the end of hospitalization (4.19, P < 0.05). Based on a cut-off NLR of 7.12, this index predicted in-hospital mortality with a sensitivity of 82.61% and specificity of 72.20% (area under ROC curve, 0.799). Predictive power was greater for the combination of NLR and serum levels of C-reactive protein and procalcitonin. These results suggest that NLR may be useful for predicting prognosis in Chinese adults with community-acquired pneumonia, and it may work better in combination with traditional markers.

scholarly journals Elderly Male With Cardiovascular-Related Comorbidities Has a Higher Rate of Fatal Outcomes: A Retrospective Study in 602 Patients With Coronavirus Disease 2019

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiao-Yong Zhan ◽  
Liang Li ◽  
Yuhai Hu ◽  
Qiang Li ◽  
Huimin Kong ◽  
...  
Keyword(s):  
Neutrophil Count ◽  
Lymphocyte Count ◽  
Fatal Outcome ◽  
The Elderly ◽  
C Reactive Protein ◽  
Elderly Male ◽  
Cox Regression Analysis ◽  
Protein Levels ◽  
Reactive Protein ◽  
D Dimer

Elderly with comorbidities have shown a higher rate of fatal outcomes when suffering coronavirus disease 2019 (COVID-19). However, a delineation of clinical significances of hematologic indices and underlying comorbidities in the progression and outcome of COVID-19 remains undefined. Six hundred two COVID-19 patients with established clinical outcomes (discharged or deceased) from Hankou Hospital of Wuhan, China between January 14, 2020 and February 29, 2020 were retrospectively analyzed. Of the 602 patients with COVID-19, 539 were discharged and 63 died in the hospital. The deceased group showed higher leukocyte and neutrophil counts but lower lymphocyte and platelet counts. Longer activated partial thromboplastin time (APTT) and prothrombin time (PT), as well as higher D-dimer and C-reactive protein levels, were found in non-survivors. Our observations suggest that these parameters could serve as potential predictors for the fatal outcome and in the discharged group. A higher neutrophil count and D-dimer level but lower lymphocyte were associated with a longer duration of hospitalization. A multivariable Cox regression analysis showed that higher neutrophil count, prolonged PT, and low lymphocyte count were risk factors for patients with COVID-19. Also, we found an association of lower lymphocyte count and higher C-reactive protein levels with the elderly group and those with cardiovascular-related comorbidities. The significantly different hematologic profiles between survivors and non-survivors support that distinct hematologic signatures in COVID-19 patients will dictate different outcomes as a prognostic marker for recovery or fatality. Lymphopenia and aggressive inflammatory response might be major causes for fatal outcomes in the elderly male and especially those with cardiovascular-related comorbidities.

scholarly journals C-Reactive Protein Levels of Sepsis Patients: A Comparison of Three Immunoassay Methods

2019 ◽  
Vol 26 (1) ◽  
pp. 1
Author(s):  
Devi Rahmadhona ◽  
Aryati Aryati ◽  
Hardiono Hardiono
Keyword(s):  
Sepsis Group ◽  
C Reactive Protein ◽  
Sepsis Diagnosis ◽  
Protein Levels ◽  
Reactive Protein ◽  
Significant Difference ◽  
Failure Assessment ◽  
Intensive Observation ◽  
Internal Medicine Wards ◽  
Selection Of

Quick Sequential Organ Failure Assessment (qSOFA) is a modification of the SOFA score that replaces the Systemic Inflammatory Response Syndrome (SIRS) criteria for sepsis diagnosis. C-reactive protein (CRP) is a marker to help diagnose sepsis. There are not many studies about comparison of CRP level with a variety of instruments and methods, currently. This study aimed to analyze differences in CRP results with particle enhanced turbidimetric immunoassay (PETIA), sandwich immunodetection and reflectometry-immunoassay patients. The study used samples of sepsis patients who were treated in emergency care unit, intensive observation rooms, Intensive Care Unit (ICU) and internal medicine wards of the Dr. Soetomo Hospital Surabaya in May-September 2018. A total of 65 sampels of sepsis patient fulfilled the qSOFA criteria. The CRP examination with the three methods were conducted on all study samples. There were significant differences in CRP levels in the sepsis group using the PETIA and Reflectometry immunoassay methods (p = 0.003), thus both of methods cannot be replace each other. There was no significant difference between CRP levels with PETIA and Sandwich Immunodetection (p=0.172) as well as Reflectometry immunoassay and Sandwich Immunodetection (p=0.251). The selection of instruments and methods for CRP examination is adjusted to laboratory needs and facilities.

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