The Value of a Complete Blood Count (CBC) for Sepsis Diagnosis and Prognosis

Sepsis represents an important global health burden due to its high mortality and morbidity. The rapid detection of sepsis is crucial in order to prevent adverse outcomes and reduce mortality. However, the diagnosis of sepsis is still challenging and many efforts have been made to identify reliable biomarkers. Unfortunately, many investigated biomarkers have several limitations that do not support their introduction in clinical practice, such as moderate diagnostic and prognostic accuracy, long turn-around time, and high-costs. Complete blood count represents instead a precious test that provides a wealth of information on individual health status. It can guide clinicians to early-identify patients at high risk of developing sepsis and to predict adverse outcomes. It has several advantages, being cheap, easy-to-perform, and available in all wards, from the emergency department to the intensive care unit. Noteworthy, it represents a first-level test and an alteration of its parameters must always be considered within the clinical context, and the eventual suspect of sepsis must be confirmed by more specific investigations. In this review, we describe the usefulness of basic and new complete blood count parameters as diagnostic and prognostic biomarkers of sepsis.

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Establishment of reference intervals of complete blood count for twin pregnancy

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04192-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yifan Zeng ◽

Lei Li ◽

Man Mao ◽

Xinghua Liang ◽

Min Chen ◽

...

Keyword(s):

Blood Cell ◽

Twin Pregnancy ◽

Blood Count ◽

Complete Blood Count ◽

White Blood Cells ◽

Reference Intervals ◽

Adverse Outcomes ◽

Prognostic Indicators ◽

Adverse Pregnancy ◽

Twin Pregnancies

Abstract Background Twin pregnancy poses a high risk, and its incidence has increased in recent years. Establishment of reference intervals of complete blood count (CBC) for women with twin pregnancies during pregnancy may aid in the prognosis of adverse outcomes. Methods The incidence of complications and the intensity associated with adverse outcomes were analyzed in 1153 cases of twin pregnancy. A total of 253 cases in the twin pregnancy reference cohort were screened from all candidates after complications and adverse pregnancy outcomes were excluded. Complete blood count data were collected during the mid- and late-term of pregnancy and analyzed using SPSS to establish the reference intervals for peripheral blood in twin pregnancy. Results Premature rupture of the membrane and pelvic inflammatory disease were highly positively correlated with adverse outcomes, with OR values of 3.31 and 3.81, respectively. Within the interval population with normal outcomes, red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), and platelet (PLT) values were lower in twin-pregnant women during gestation than in healthy nulligravida women, but the levels of white blood cells (WBC), neutrophils (NEU), and the NEU% increased, especially in the mid-term. The reference intervals of late-term pregnancy were validated using 20 twin pregnancies samples, and then utilized to determine the distinctive CBC characteristics in preterm birth (PTB) pregnancy. Absolute WBC and NEU values increased in PTB pregnancy based on our established reference intervals, which suggests that these may might be prognostic indicators of this adverse outcome. Conclusion Establishing the reference interval of blood cell-related indicators of normal twin pregnancy is helpful for the monitoring and prognosis of gestation.

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Diagnostic and Prognostic Value of Routine Blood Tests in Patients with COVID-19 in Iran, Tehran

Journal of Iranian Medical Council ◽

10.18502/jimc.v4i3.7213 ◽

2021 ◽

Author(s):

Behzad Asanjarani ◽

Goli Siri ◽

Seyed Mahmoud Eshagh Hosseini ◽

Hamed Abdollahi ◽

Mehrdad Hasibi ◽

...

Keyword(s):

Blood Count ◽

Complete Blood Count ◽

Adverse Outcomes ◽

Control Group ◽

Laboratory Findings ◽

Distribution Width ◽

Neutrophil Lymphocyte Ratio ◽

Routine Blood ◽

Novel Coronavirus ◽

Comprehensive Metabolic Panel

Background: Routine blood testing consists of Complete Blood Count (CBC) indices together with Comprehensive Metabolic Panel (CMP) which have significant roles in both diagnosis and prognosis of the novel coronavirus disease 2019 (COVID-19). Methods: A total number of 942 COVID-19 patients and 400 healthy persons as the control group were enrolled in this study. All patients were admitted to a single center and were divided into two groups according to disease severity (severe or non-severe). Routine laboratory findings of peripheral blood sample were collected and then analyzed. Results: Neutrophil-Lymphocyte Ratio (NLR) had the highest sensitivity and specificity value for COVID-19 diagnosis. Among patients with different severities of COVID-19, the amount of neutrophil, NLR, platelet, hemoglobin, Red cell Distribution Width (RDW) and total bilirubin was significantly different (p<0.01). Conclusion: Some indices of complete blood count and comprehensive metabolic panel have diagnostic and prognostic roles in COVID-19 patients, which are helpful in early diagnosis, predicting severity and adverse outcomes of patients with COVID-19.

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Monocyte distribution width (MDW) performance as an early sepsis indicator in the emergency department: comparison with CRP and procalcitonin in a multicenter international European prospective study

Critical Care ◽

10.1186/s13054-021-03622-5 ◽

2021 ◽

Vol 25 (1) ◽

Author(s):

Pierre Hausfater ◽

Neus Robert Boter ◽

Cristian Morales Indiano ◽

Marta Cancella de Abreu ◽

Adria Mendoza Marin ◽

...

Keyword(s):

Emergency Department ◽

Blood Count ◽

Complete Blood Count ◽

C Reactive Protein ◽

Systematic Screening ◽

Distribution Width ◽

Sepsis Diagnosis ◽

Reactive Protein ◽

Early Sepsis ◽

Sepsis Detection

Abstract Background Early sepsis diagnosis has emerged as one of the main challenges in the emergency room. Measurement of sepsis biomarkers is largely used in current practice to improve the diagnosis accuracy. Monocyte distribution width (MDW) is a recent new sepsis biomarker, available as part of the complete blood count with differential. The objective was to evaluate the performance of MDW for the detection of sepsis in the emergency department (ED) and to compare to procalcitonin (PCT) and C-reactive protein (CRP). Methods Subjects whose initial evaluation included a complete blood count were enrolled consecutively in 2 EDs in France and Spain and categorized per Sepsis-2 and Sepsis-3 criteria. The performance of MDW for sepsis detection was compared to that of procalcitonin (PCT) and C-reactive protein (CRP). Results A total of 1,517 patients were analyzed: 837 men and 680 women, mean age 61 ± 19 years, 260 (17.1%) categorized as Sepsis-2 and 144 patients (9.5%) as Sepsis-3. The AUCs [95% confidence interval] for the diagnosis of Sepsis-2 were 0.81 [0.78–0.84] and 0.86 [0.84–0.88] for MDW and MDW combined with WBC, respectively. For Sepsis-3, MDW performance was 0.82 [0.79–0.85]. The performance of MDW combined with WBC for Sepsis-2 in a subgroup of patients with low sepsis pretest probability was 0.90 [0.84–0.95]. The AUC for sepsis detection using MDW combined with WBC was similar to CRP alone (0.85 [0.83–0.87]) and exceeded that of PCT. Combining the biomarkers did not improve the AUC. Compared to normal MDW, abnormal MDW increased the odds of Sepsis-2 by factor of 5.5 [4.2–7.1, 95% CI] and Sepsis-3 by 7.6 [5.1–11.3, 95% CI]. Conclusions MDW in combination with WBC has the diagnostic accuracy to detect sepsis, particularly when assessed in patients with lower pretest sepsis probability. We suggest the use of MDW as a systematic screening test, used together with qSOFA score to improve the accuracy of sepsis diagnosis in the emergency department. Trial Registration ClinicalTrials.gov (NCT03588325).

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Hematologic response and serum and peritoneal fluid proteinogram of cattle affected by intestinal diseases and traumatic reticuloperitonitis

Semina Ciências Agrárias ◽

10.5433/1679-0359.2021v42n1p209 ◽

2021 ◽

Vol 42 (1) ◽

pp. 209-228

Author(s):

Jomel Francisco dos Santos ◽

◽

Rafael Otaviano do Rego ◽

José Augusto Bastos Afonso ◽

José Jurandir Fagliari ◽

...

Keyword(s):

Peritoneal Fluid ◽

Blood Count ◽

Complete Blood Count ◽

Intestinal Diseases ◽

Hematologic Response ◽

Diagnosis And Prognosis ◽

Digestive Diseases ◽

Sds Page ◽

Clinical Changes ◽

Traumatic Reticuloperitonitis

This study aimed to evaluate the hematologic response and the serum and peritoneal fluid (PF) proteinogram of cattle affected by digestive diseases. Twenty-seven animals were distributed in two groups: GI (intestinal diseases) and GII (traumatic reticuloperitonitis, TRP). The animals were previously submitted to a physical exam. Subsequently, blood samples were collected to perform the complete blood count, determine the plasma protein and fibrinogen, and obtain the serum for proteinogram in polyacrylamide gel (SDS-PAGE). Simultaneously, PF was collected to perform physical and chemical evaluation and the electrophoretic profile (SDS-PAGE). ANOVA at the 5% probability level was used to compare the groups. The animals showed signs of apathy, dehydration, and gastrointestinal hypomotility in both groups. However, GI animals showed more significant clinical changes. The blood count of both groups (P > 0.05) showed leukocytosis due to neutrophilia and a regenerative left shift with hyperfibrinogenemia. The proteinogram of both body fluids allowed the identification of proteins albumin (ALB), transferrin (TRF), ceruloplasmin, haptoglobin, ?1-acid glycoprotein (?1-AGP), MW 23000 Da, ?1-antitrypsin, IgA, and IgG. The [PT] PF/[PT] blood serum ratio of each of the identified proteins increased, showing statistical differences between groups (P < 0.05) regarding PT, ALB, TRF, ?1-AGP, and IgG values, with GI animals showing the highest ratio. Intestinal diseases and TRP triggered a systemic and local response characterized by clinical, hematological, and serum and PF proteinogram alterations. The proteins ?1-GPA, haptoglobin, and TRF measured in PF were good inflammation biomarkers and useful as an auxiliary tool for the diagnosis and prognosis of digestive diseases in cattle.

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Establish Reference Intervals of Complete Blood Count for Twin Pregnancy

10.21203/rs.3.rs-154564/v1 ◽

2021 ◽

Author(s):

Yifan Zeng ◽

Lei Li ◽

Man Mao ◽

Xinghua Liang ◽

Min Chen ◽

...

Keyword(s):

Pregnant Women ◽

Twin Pregnancy ◽

Blood Count ◽

Complete Blood Count ◽

Reference Interval ◽

Reference Intervals ◽

Adverse Outcomes ◽

Adverse Pregnancy ◽

Reference Cohort ◽

Normal Twin

Abstract Background: Twin pregnancy is of high risk, which increased in recent years. Establishment of reference intervals of complete blood count (CBC) for twin-pregnant women during pregnancy might help for the properly prognosis of adverse outcomes in twin pregnancy. Methods: We screened out 253 cases of twin pregnancy reference cohort from 1153 twin pregnancy after the complications and adverse pregnancy outcomes were excluded. Complete blood count data were collected during the mid- and late-term of pregnancy and analyzed by SPSS to establish the reference intervals of peripheral blood of twin pregnancy. Results: The RBC, HGB, HCT, and PLT were lower in twin pregnant women than those in healthy nulligravida women during gestation, while the levels of WBC, NEU, and NEU% increased, especially in the mid-term. The reference intervals of late-term pregnancy validated by using 20 samples of twin pregnancy, then utilized for figuring out the distinctive characteristics of CBC with preterm birth (PTB) pregnancy. Absolutes of WBC and NEU increased in PTB pregnancy using our established reference intervals, implying they might be prognosis indicators of this adverse outcome. Conclusion: Establishing the reference interval of blood cell-related indicators of normal twin pregnancy is helpful for the monitoring and prognosis of PTB.

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Clinical Significance of MicroRNAs in Patients with Sepsis: Protocol for a Systematic Review and Meta-Analysis

Diagnostics ◽

10.3390/diagnostics9040211 ◽

2019 ◽

Vol 9 (4) ◽

pp. 211

Author(s):

Daisuke Hasegawa ◽

Kazuma Yamakawa ◽

Kohei Taniguchi ◽

Shuhei Murao ◽

Osamu Nishida

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Sensitivity Analyses ◽

Bibliographic Databases ◽

Published Data ◽

Cochrane Central Register ◽

Summary Receiver Operating Characteristic ◽

Sepsis Diagnosis ◽

Diagnosis And Prognosis ◽

Prognostic Accuracy

Sepsis is a dysregulated immune response that leads to organ dysfunction and has high mortality rates despite recent therapeutic advancements. Accurate diagnosis and risk stratification are important for effective sepsis treatment; however, no decisive diagnostic or prognostic biomarkers are currently available. To understand whether microRNA (miRNA) might be useful biomarkers of sepsis, we aim to assess the diagnostic and prognostic accuracy of three miRNAs (122, 150, and 223) in sepsis patients via a meta-analysis of relevant published data. We will search electronic bibliographic databases (MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials) for pertinent retrospective and prospective studies in October 2019. Two reviewers will evaluate the collected titles, abstracts, and full articles, and extract the data. We will assess the included studies using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. If feasible, we will use bivariate random effects and hierarchical summary receiver operating characteristic (ROC) models to estimate summary ROCs, pooled sensitivity and specificity values, and the corresponding 95% confidence intervals. We will evaluate heterogeneity via clinical and methodological subgroup and sensitivity analyses. This systematic review will clarify the diagnostic and prognostic accuracy of select miRNAs in sepsis. It may also identify knowledge gaps in sepsis’ diagnosis and prognosis.

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Drug-Induced Agranulocytosis: A Mini Review

Research in Pharmacy and Health Sciences ◽

10.32463/rphs.2016.v02i01.11 ◽

2016 ◽

Vol 2 (1) ◽

pp. 57-59

Author(s):

Pavithra D ◽

Praveen D ◽

Vijey Aanandhi M

Keyword(s):

Bone Marrow ◽

Complete Blood Count ◽

Genetic Manipulation ◽

White Blood Cells ◽

Deep Infection ◽

Morbidity Rate ◽

Drug Induced ◽

Serious Adverse Event ◽

Mortality And Morbidity ◽

The Individual

Agranulocytosis is also known to be granulopenia, causing neutropenia in circulating blood streams .The destruction of white blood cells takes place which leads to increase in the infection rate in an individual where immune system of the individual is suppressed. The symptoms includes fever, sore throat, mouth ulcers. These are commonly seen as adverse effects of a particular drug and are prescribed for the common diagnostic test for regular monitoring of complete blood count in an admitted patient. Drug-induced agranulocytosis remains a serious adverse event due to occurrence of severe sepsis with deep infection leading to pneumonia, septicaemia, and septic shock in two/third of the patient. Antibiotics seem to be the major causative weapon for this disorder. Certain drugs mainly anti-thyroid drugs, ticlopidine hydrochloride, spironolactone, clozapine, antileptic drugs (clozapine), non-steroidal anti-inflammatory agents, dipyrone are the potential causes. Bone marrow insufficiency followed by destruction or limited proliferative bone marrow destruction takes place. Chemotherapy is rarely seen as a causative agent for this disorder. Genetic manipulation may also include as one of the reason. Agranulocytosis can be recovered within two weeks but the mortality and morbidity rate during the acute phase seems to be high, appropriate adjuvant treatment with broad-spectrum antibiotics are prerequisites for the management of complicated neutropenia. Drugs that are treated for this are expected to change as a resistant drug to the patient. The pathogenesis of agranulocytosis is not yet known. A comprehensive literature search has been carried out in PubMed, Google Scholar and articles pertaining to drug-induced agranulocytosis were selected for review.

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