Immature granulocyte percentage for prediction of sepsis in severe burn patients: a machine leaning-based approach

Abstract

Background Of the existing sepsis markers, immature granulocytes (IG) most frequently reflect the presence of an infection. The importance of IG as an early predictor of sepsis and bacteremia is evaluated differently for each study. This study aimed to evaluate the effectiveness of the Sysmex XN series’ IG% as an independent prognostic indicator of sepsis using machine learning. Methods A total of 2465 IG% results from 117 severe burn patients in the intensive care unit of one institution were retrospectively analyzed. We evaluated the IG% for sepsis using the receiver operating characteristic, logistic regression, and partial dependence plot analyses. Clinical characteristics and other laboratory markers associated with sepsis, including WBC, procalcitonin, and C-reactive protein, were compared with the IG% values. Results Twenty-six of the 117 patients were diagnosed with sepsis. The median IG% value was 2.6% (95% CI: 1.4–3.1). The area under the receiver operating characteristic curve was 0.77 (95% CI: 0.78–0.84) and the optimal cut-off value was 3%, with a sensitivity of 76.9% and specificity of 68.1%. The partial dependence plot of IG% on predicting sepsis showed that an IG% < 4% had low predictability, but increased thereafter. The interaction plot of IG% and C-reactive protein showed an increase in sepsis probability at an IG% of 6% and C-reactive protein of 160 mg/L. Conclusions IG% is moderately useful for predicting sepsis. However, since it can be determined from routine laboratory test results and requires no additional intervention or cost, it could be particularly useful as an auxiliary marker.

Phenotypic Landscape of Immune Cells in Sepsis: Insights from High-Dimensional Mass Cytometry

“…These unassigned cells may represent known cell types altered significantly under sepsis, making them unrecognizable by conventional markers, or they may be a novel subtype of immune cells that emerge in response to sepsis. Furthermore, the unassigned cells could be immature granulocytes, given that sepsis is known to induce the recruitment of immature neutrophils into the bloodstream. − The presence of these unassigned cells could indicate a potentially unexplored mechanism of immune response modulation in sepsis, suggesting that further research into their identity is crucial to uncovering new facets of immune system behavior in response to severe infection and systemic inflammation. The unassigned cells observed in this study require more thorough exploration, and we emphasize the need for further research to expand our understanding of these cells.…”

Early Detection of Blood Culture Positivity in Pediatric Cardiac Surgery Patients Using Immature Granulocyte Percentage and Absolute Count

“…Several studies have examined the association between immature granulocyte counts (IG# and IG%) and blood culture positivity in pediatric patients with cardiac disease [14,15]. In a study published in the Journal of Clinical Laboratory Analysis in 2018, it was observed that patients with positive blood cultures exhibited significantly higher immature granulocyte counts (IG# and IG%) compared to those with negative blood cultures.…”

Does the Percentage of Immature Granulocytes Predict the Severity and Mortality of the Disease in Patients with Acute Pancreatitis Presenting to the Emergency Department?

“…In a study conducted on patients with sepsis in 2019, Ayres et al [11] found the IG percentage was significant in demonstrating sepsis. Jeon et al [12] found that the percentage of IG was moderately significant in demonstrating sepsis in patients who developed sepsis after burns in 2021. Karon et al [13] in 2017, found that the percentage of IG was moderately significant in showing sepsis in sepsis patients.…”