Epidemiology and Prognostic Utility of Cellular Components of Hematological System in Sepsis

Saxena, Renu; Rewari, Vimi; Arora, Manali; Batra, Ramesh; Sinha, Harsha

doi:10.5005/jp-journals-10071-23874

Cited by 7 publications

(8 citation statements)

References 34 publications

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“…However, only one study explored the role of basophils in patients with sepsis. The authors showed that septic critically ill patients with decreased basophil count at admission to ICU had an increased mortality risk [57].…”

Section: Basophilsmentioning

confidence: 99%

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

et al. 2021

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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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Section: Basophilsmentioning

confidence: 99%

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

et al. 2021

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“…Similarly, Sinha et al. discovered that platelet count on the first day of admission could predict 28-day mortality in sepsis patients ( 32 ). However, these studies were limited to specific sepsis infections or excluded conditions such as hematological disorders and cancer, which are common complications of cancer treatment ( 33 ).…”

Section: Discussionmentioning

confidence: 99%

A simplified machine learning model utilizing platelet-related genes for predicting poor prognosis in sepsis

Diao,

Zhao,

et al. 2023

Front. Immunol.

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BackgroundThrombocytopenia is a known prognostic factor in sepsis, yet the relationship between platelet-related genes and sepsis outcomes remains elusive. We developed a machine learning (ML) model based on platelet-related genes to predict poor prognosis in sepsis. The model underwent rigorous evaluation on six diverse platforms, ensuring reliable and versatile findings.MethodsA retrospective analysis of platelet data from 365 sepsis patients confirmed the predictive role of platelet count in prognosis. We employed COX analysis, Least Absolute Shrinkage and Selection Operator (LASSO) and Support Vector Machine (SVM) techniques to identify platelet-related genes from the GSE65682 dataset. Subsequently, these genes were trained and validated on six distinct platforms comprising 719 patients, and compared against the Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ-Failure Assessment (SOFA) score.ResultsA PLT count <100×109/L independently increased the risk of death in sepsis patients (OR = 2.523; 95% CI: 1.084-5.872). The ML model, based on five platelet-related genes, demonstrated impressive area under the curve (AUC) values ranging from 0.5 to 0.795 across various validation platforms. On the GPL6947 platform, our ML model outperformed the APACHE II score with an AUC of 0.795 compared to 0.761. Additionally, by incorporating age, the model’s performance was further improved to an AUC of 0.812. On the GPL4133 platform, the initial AUC of the machine learning model based on five platelet-related genes was 0.5. However, after including age, the AUC increased to 0.583. In comparison, the AUC of the APACHE II score was 0.604, and the AUC of the SOFA score was 0.542.ConclusionOur findings highlight the broad applicability of this ML model, based on platelet-related genes, in facilitating early treatment decisions for sepsis patients with poor outcomes. Our study paves the way for advancements in personalized medicine and improved patient care.

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“… 10 This is similar to other studies performed on critically ill patients. 5 , 6 , 10 This led us to conclude that measuring vitamin D levels before supplementation would not translate to pragmatic ICU practice. Secondly, there have been reports in the literature that the serum vitamin D levels are subject to diurnal variations and a single random value may not be representative of the actual picture.…”

Section: Discussionmentioning

confidence: 99%

“…As per the database of the past 2 years of sepsis patients in our ICU, the mean length of ICU stay was 10 ± 4 days. 6 Considering a decrease in ICU stay of 2 days in the intervention group to be significant, the sample size calculated with a confidence interval of 95%, 80% power of the study and a 1:1 enrolment ratio for intervention and placebo was 126 with 63 in each group. Statistical analysis was performed using SPSS 26.0 (IBM Corp, USA) It was performed based on the intention to treat principle.…”

Section: Ethodsmentioning

confidence: 99%

“…Although a few large randomized controlled trials (RCTs) in heterogeneous intensive care unit (ICU) patients failed to demonstrate any clinical benefit of administration of vitamin D, early supplementation of vitamin D appears to have a sound theoretical basis, especially in the vulnerable sepsis subpopulation. 5 , 6 This study was planned to identify if early administration of vitamin D can reduce ICU length of stay and improve clinical outcomes in critically ill patients with sepsis.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Early Administration of Vitamin D on Clinical Outcome in Critically Ill Sepsis Patients: A Randomized Placebo-controlled Trial

Bhattacharyya¹,

Subramaniam²,

Baidya³

et al. 2022

Indian Journal of Critical Care Medicine

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A bstract Background Administration of vitamin D to unselected heterogeneous critically ill patients did not demonstrate outcome benefit. The current study was undertaken to identify if early administration of vitamin D can reduce intensive care unit (ICU) length of stay and improve clinical outcomes in critically ill patients with sepsis. Methods This single-center randomized double-blind placebo-controlled trial was done in the ICU and emergency inpatient ward of a tertiary care teaching institute in New Delhi, India. A total of 126 adult patients aged 18 to 80 years of either sex diagnosed to have sepsis were included within 24 hours of admission to the hospital and randomized into vitamin D or placebo groups. The patients in the intervention group received vitamin D3 540,000 units dissolved in 45 mL of milk. The placebo group received 45 mL of milk. Results The median length of ICU stay (8 vs 9 days; p = 0.32), median length of hospital stay (12 vs 12 days; p = 0.33), median duration of vasopressors requirement (4 vs 3 days; p = 0.84), median duration of mechanical ventilation (5 vs 7 days; p = 0.23), requirement of tracheostomy (34 vs 39%; p = 0.71), and 90-day mortality [35 vs 46%; p = 0.29; HR 0.72 (0.42–1.24)] were similar in vitamin D and placebo arm. A subgroup analysis in patients with severe vitamin D deficiency (vitamin D <12 ng/mL) revealed a significantly decreased incidence of tracheostomy (28 vs 57%; p = 0.04), a trend toward decreased 90-day mortality [34 vs 66%; p = 0.08; HR 0.44 (0.19–1.01)], and duration of mechanical ventilation (6 vs 11 days; p = 0.05) in patients receiving vitamin D. Conclusion Administration of large-dose vitamin D within 24 hours of admission does not reduce the length of ICU stay in critically ill sepsis patients. How to cite this article Bhattacharyya A, Subramaniam R, Baidya DK, Aggarwal P, Wig N. Effect of Early Administration of Vitamin D on Clinical Outcome in Critically Ill Sepsis Patients: A Randomized Placebo-controlled Trial. Indian J Crit Care Med 2021;25(10):1147–1154.

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Epidemiology and Prognostic Utility of Cellular Components of Hematological System in Sepsis

Cited by 7 publications

References 34 publications

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

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

A simplified machine learning model utilizing platelet-related genes for predicting poor prognosis in sepsis

Effect of Early Administration of Vitamin D on Clinical Outcome in Critically Ill Sepsis Patients: A Randomized Placebo-controlled Trial

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