CD64 Index as a Predictor of Outcome for Children with Systemic Inflammatory Response Syndrome (SIRS)

Abstract

Sepsis is one of the major causes of mortality and morbidity in children. The study aimed to assess the prognostic value and difference of Neutrophil CD64 index regarding sepsis outcome. Methods of this study were a prospective observational study in 62 children with Systemic Inflammatory Response Syndrome (SIRS) were conducted in ER and Pediatric Ward Dr. M. Djamil Hospital, Padang. We collected blood samples to measure Neutrophil CD64 index and blood cultures were drawn to confirm infection. Patients were observed clinically until discharge from the hospital. Based on the clinical course and laboratory test results, patients were categorized as having unproven sepsis, sepsis, septic shock, and nonsurvivor. The average Neutrophil CD64 index were 1.13±0.32; 1.71±0.23; 2.29±0.71; 2.86±1.10 for unproven sepsis, sepsis, septic shock, and nonsurvivors, respectively. The area under the curve (AUC) for hospital mortality was 0.863. At a cutoff level of 1.705 sensitivity was 71.4% and specificity was 72.9%. Patients with CD64 index level higher than 1.705 had 6.7-fold higher probability of dying. The odd ratio is 6.7 (95% CI 1.79-25.27). Neutrophil CD64 was significantly elevated as a severe outcome of sepsis. This result indicates that neutrophil CD64 may be used as a biomarker for predicting mortality.