Evaluation of lactate, white blood cell count, neutrophil count, procalcitonin and immature granulocyte count as biomarkers for sepsis in emergency department patients

Karon, Brad S.; Tolan, Nicole V.; Wockenfus, Amy M.; Block, Darci R.; Baumann, N; Bryant, Sandra C.; Clements, Casey M.

doi:10.1016/j.clinbiochem.2017.05.014

Cited by 58 publications

(42 citation statements)

References 12 publications

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“…Ha et al found a similar cutoff value for IG% (0.5%) when evaluating IG% ability to discriminate between complicated and uncomplicated sepsis compared to other biomarkers (white blood cells, C‐reactive protein, lactate, and procalcitonin concentrations). Another study, comparing lactate, white blood cell (WBC) and neutrophil count, procalcitonin and immature granulocyte (IG) count for the prediction of sepsis, and severe sepsis or septic shock, established a 0.2% cutoff for IG%, with 67.0% specificity and 45.7% sensitivity . However, in clinical practice, the implementation of such low cutoff values would increase the false‐positive diagnosis, as demonstrated by the low specificity found in the present study through ROC analyses (45.5% for IG% of 0.3% and 29.5% for IG% of 0.4%).…”

Section: Discussionmentioning

confidence: 55%

Immature granulocytes index as early marker of sepsis

Ayres

Sgnaolin

Munhoz

2019

Int J Lab Hematology

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Introduction Sepsis induces the recruitment of immature neutrophils into the circulation. An immature granulocyte percentage (IG%) count greater than 3% has been shown to be an indicator for the risk of sepsis. The aim of this study was to evaluate the IG% as predictor of sepsis compared to blood culture results and sepsis diagnostic confirmation. Methods The study included individuals (n = 301) of both sexes aged ≥18 years who underwent Hospital São Lucas examinations between January and November 2017. For all the patients, IG%, as well as blood culture results, were evaluated. All examinations were obtained from Clinical Laboratory database. Data were analyzed through the SPSS program version 18.0. Results There was statistical association between blood culture and IG% results (P = 0.009) and between sepsis confirmation and IG% on Pearson chi‐square test (P < 0.001). An IG% cutoff point of 2.0% was able to exclude sepsis based on clinical diagnosis with a specificity of 90.9% and a sensitivity of 38.5%. The cutoff value in ROC analyses of IG% based on blood culture results was 0.3% and 0.4% based on clinical diagnosis. Conclusion Our study demonstrated that IG% <2.0% are helpful on the exclusion of sepsis diagnosis with a very high specificity (90.9%). The IG% is a useful additional marker for sepsis diagnosis allowing the early initiation of therapy and better possibilities of recovery.

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Section: Discussionmentioning

confidence: 55%

Immature granulocytes index as early marker of sepsis

Ayres

Sgnaolin

Munhoz

2019

Int J Lab Hematology

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“…Studies have indicated that the IGC and IG% reflect an infection-related response and may be associated with mortality. 11 Studies on the role of inflammatory biomarkers in the assessment of massive bleeding have increased in recent years. In a present study, a positive correlation between increased CRP values and gastrointestinal bleeding has been shown.…”

Section: Discussionmentioning

confidence: 99%

“…IG and its derivatives are known to be new systemic inflammation biomarkers expressed in various conditions such as systemic inflammation. 11 , 21 A study states that the IG% showed appendicitis complications with low sensitivity and high specificity. 22 A study by Kong et al .…”

Section: Discussionmentioning

confidence: 99%

“… 9 , 10 With the latest technological developments, IG can be measured easily and quickly on automated blood cell analyzers. 11 Studies have shown that IG is useful for predicting the severity of many disease processes, including gastrointestinal tract diseases. In addition, increased IG has been reported to be strongly associated with systemic inflammation and mortality.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, increased IG has been reported to be strongly associated with systemic inflammation and mortality. 11 – 13 The role of IG in UGIB patients in terms of clinical utility and as a marker for mortality has not yet been investigated. Therefore, the aim of the study is to evaluate IG, which can be obtained from simple hemogram tests in patients with UGIB, in terms of clinical use and as a mortality marker.…”

Section: Introductionmentioning

confidence: 99%

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Immature Granulocyte Count and Percentage as New Predictors of Mortality in Patients with Upper Gastrointestinal Bleeding

Bedel¹,

Korkut²,

Avcı³

et al. 2020

Indian Journal of Critical Care Medicine

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A bstract Aims Early identification of patients at risk of adverse outcomes may increase the survival rates in patients with upper gastrointestinal bleeding (UGIB), but this can be difficult to predict in emergencies. The aim of the study is to evaluate immature granulocyte (IG), which can be obtained from simple hemogram tests in patients with UGIB, in terms of clinical use and as a mortality marker. Materials and methods The patients diagnosed with UGIB between March 1, 2019, and September 30, 2019, were evaluated retrospectively. Demographic characteristics, causes of hemorrhage, clinical presentations, hemogram, and biochemistry values at ED admission and 30-day mortality status of the patients were examined. We divided the patients into groups according to their mortality status, and the groups were compared among themselves in terms of parameters. Results A total of 213 patients who met the inclusion criteria were included in the study. Of these patients, 139 (65.3%) were male and the mean age was 65.05 ± 16.7 years. Fifteen (7%) of them were in the nonsurvival group, while 198 (93%) were in the survival group. The efficacy of both the IG count (IGC) and IG% in predicting mortality was statistically significant ( p = 0.002, p = 0.008, respectively). The sensitivity and specificity for the IGC were found as 60% and 84.4; for the IG%, they were found as 66.7% and 75.7%, respectively. Conclusion IGC and IG% are independent risk factors for the 30-day mortality status. These measurements are obtained from simple hemogram tests and may be useful for the evaluation of mortality in patients with UGIB. How to cite this article Bedel C, Korkut M, Avcı A, Uzun A. Immature Granulocyte Count and Percentage as New Predictors of Mortality in Patients with Upper Gastrointestinal Bleeding. Indian J Crit Care Med 2020;24(9):794–798.

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