Aims The cell population data (CPD) parameters reported by XN analyser (Sysmex, Kobe, Japan) reflect the size and internal structure of leucocytes. We aimed to assess the clinical utility of these parameters as biomarkers for the early diagnosis of sepsis.
Methods The study group (G1) included 586 controls (no quantitative or morphological alterations in the complete blood count) and 137 patients diagnosed with sepsis. The reliability of the model was evaluated using a validation group (G2) of 212 controls and 60 patients with sepsis. The optimal cut-off for the diagnosis of sepsis and the OR for CPD were established using a univariate logistic regression. A multivariate logistic regression model was then created. The OR and area under the curve were recorded. A risk stratification scale (neutrophils and monocytes (NEMO)) for diagnosing sepsis was established on the basis of the coefficients of the multivariate model.
Results MO-X and neutrophils fluorescence intensity (NE-SFL) were found to be the most relevant of the CPD in predicting sepsis applying multivariate analysis to G1.NEMO score was composed using the above-mentioned CPD and subsequently stratified into three risk groups: mild (≤3), moderate (4≤NEMO≤5) and high (≥6). The OR for patients with a score of 4–5 was 10 and 249 for a score of ≥6. When applied to G2, the positive predictive value was 84.8 % and the negative predictive value was 96.0%.
Conclusions CPD are potentially useful for the early diagnosis of sepsis. Their values were used to compose in NEMO score can help in rapid and reliable decision making.
- clinical infectious diseases
- neutrophil function
- diagnostic screening
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Handling editor Runjan Chetty.
Contributors EU: Conception or design of the work, drafting the article, critical revision of the article, final approval of the version to be published. OB: data collection, critical revision of the article, final approval of the version to be published. UA: Conception or design of the work, data analysis and interpretation, critical revision of the article, final approval of the version to be published.
Competing interests None declared.
Ethics approval Research Ethics Committee the Barrualde-Interior District IHO (Biscay, Spain).
Provenance and peer review Not commissioned; externally peer reviewed.