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Innovative haematological parameters for early diagnosis of sepsis in adult patients admitted in intensive care unit
  1. Sabrina Buoro1,
  2. Barbara Manenti1,
  3. Michela Seghezzi1,
  4. Paola Dominoni1,
  5. Tiziano Barbui2,
  6. Arianna Ghirardi2,
  7. Alessandra Carobbio2,
  8. Gianmariano Marchesi3,
  9. Ivano Riva3,
  10. Alessandra Nasi3,
  11. Cosimo Ottomano4,
  12. Giuseppe Lippi5
  1. 1 Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
  2. 2 FROM Research Foundation, Papa Giovanni XXIII Hospital, Bergamo, Italy
  3. 3 Intensive Care Unit, Hospital Papa Giovanni XXIII, Bergamo, Italy
  4. 4 Clinical Chemistry Laboratory, Synlab, Castenedolo, Italy
  5. 5 Department of Clinical Biochemistry, University of Verona, Verona, Italy
  1. Correspondence to Dr Barbara Manenti, Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Piazza OMS 1, 24127 Bergamo, Italy; barbara.manenti{at}


Aims This study was aimed to investigate the role of erythrocyte, platelet and reticulocyte (RET) parameters, measured by new haematological analyser Sysmex XN and C reactive protein (CRP), for early diagnosis of sepsis during intensive care unit (ICU) stay.

Methods The study population consisted of 62 ICU patients, 21 of whom developed sepsis during ICU stay and 41 who did not. The performance for early diagnosing of sepsis was calculated as area under the curve (AUC) of receiver operating characteristics curves analysis.

Results Compared with CRP (AUC 0.81), immature platelet fraction (IPF) (AUC 0.82) showed comparable efficiency for identifying the onset of sepsis. The association with the risk of developing sepsis during ICU stay was also assessed. One day before the onset of sepsis, a decreased of RET% was significantly associated with the risk of developing sepsis (OR=0.35, 95% CI 0.14 to 0.87), whereas an increased of IPF absolute value (IPF#) was significantly associated with the risk of developing sepsis (OR=1.13, 95% CI 1.03 to 1.24) 2 days before the onset of sepsis. The value of CRP was not predictive of sepsis at either time points.

Conclusions IPF# and RET% may provide valuable clinical information for predicting the risk of developing sepsis, thus allowing early management of patients before the onset of clinically evident systemic infections.

  • Automated hematology analyzer
  • Sysmex
  • liver impairment
  • sepsis
  • Immature Platelet Fraction
  • reticolocytes

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  • Handling editor Mary Frances McMullin.

  • Contributors SB and GM: substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data. SB, CO, TB, GL and BM: drafting the work and/or revising it critically for important intellectual content. PD, AN, IR and MS: data collection. AC and AG: statistical analysis. All coauthors give final approval of the version submitted and/or published. All authors showed agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests None declared.

  • Patient consent Detail has been removed from this/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval Ethical committee of the Papa Giovanni XXIII Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.