Diagnostic value of biomarkers for sepsis in adult patients in the emergency department: Don't forget the neutrophil-lymphocyte count ratio
Journal Title: Journal of Acute Disease - Year 2019, Vol 8, Issue 2
Abstract
Objective: To determine and compare the diagnostic efficiency of various biomarkers [C-reactive protein, neutrophil percentage, neutrophil-lymphocyte ratio (NLCR), lactate, procalcitonin, blood culture] in the identification of septic patients in emergency department (ED), and to assess the predictive value of combination of markers. Methods: This was a prospective, single centre study conducted in the ED of an urban, tertiary care hospital. We included patients who were admitted to the ED with symptoms of a possible infection. Blood cultures and serum measurement of the biomarkers were collected from 131 patients. Patients were determined to be septic or non-septic, based on the systemic inflammatory response syndrome criteria and the diagnosis was made at the ED. Sensitivity, specificity, positive predictive value, negative predictive value and area under curves (AUC) were calculated. Results: A total of 126 patients, 61 with sepsis and 65 without sepsis were eventually included in the study. Neutrophil to lymphocyte ratio displayed the highest accuracy in diagnosing sepsis (AUC 0.735, 95% CI=0648-0.822, P<0.001). The best combination of markers in predicting sepsis was NLCR and white blood cell (AUC: 0.801, 95% CI=0.724-0.878, P<0.001). Conclusions: The results of this small study showed that NLCR outperforms other markers in diagnosing sepsis in ED. It is readily available, cost efficient, non invasive and independent. It may be insufficient to rely on this single marker to diagnose sepsis, so some other diagnostic utilities should be taken into account as one part of the overall assessment. Our study also showed that combination of NLCR and white blood cell provides the highest diagnostic accuracy. More large scale studies across different population groups will be needed to confirm this finding
Authors and Affiliations
G Visveswari, Bernadette Tan Qiao Min, Fatimah Lateef
Keywords
Related Articles
- EP ID EP484503
- DOI 10.4103/2221-6189.254411
- Views 92
- Downloads 0
Changes of inflammatory factors, reactive oxygen species and cognitive function in mice after brain-blast injury
Objective: To study the changes of cognitive function in mouse after brain-blast injury. Methods: Fourty healthy male C57BL/6 mice were randomly divided into model group and control group. After 24 h of injury, histopath...
Survival after prolonged cardiopulmonary resuscitation in cardiac arrest due to electric shock
Cardiac arrhythmias and respiratory paralysis are among the common causes of death in electric shock victims. Emergency physicians face unique challenges in stabilizing airway and spine apart from fibrillating myocardium...
Frequency and damage caused by sharp instruments and needle sticks among staff in a university hospital, Kerman, Iran
Objective: To determine the frequency and causes of injuries from sharp instruments contaminated by blood in hospital staff. Methods: The study was cross-sectional and conducted at an educational hospital supervised by K...
Detection of acute and chronic toxoplasmosis amongst multi-transfused thalassemia patients in southwest of Iran
Objective: Since pre-transfusion screening for Toxoplasma gondii is not performed on blood packs, thalassemia patients are susceptible to acquiring toxoplasmosis; thus, the aim of this study was to evaluate the seropreva...
Cost analysis and characteristics of the patients admitted to emergency service with poisoning
Objective: To investigate the cost analysis and hospitalization rates and modes of poisoning of patients who applied to Bakent University Ankara Hospital Adult Emergency Service. Methods: Poisoning Patients who applied t...