Immature granulocytes index as early marker of sepsis

Abstract

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.

A novel haemocytometric COVID-19 prognostic score developed and validated in an observational multicentre European hospital-based study

“…IGs, representing metamyelocytes, myelocytes, and promyelocytes (38), were commonly present in our patient population, especially in those more severely ill. The importance of IGs in management of sepsis has been reported (39,40). Of note, increases in neutrophil counts and neutrophil activity (NEUT-RI) were dissimilar, unlike observations in bacterial infections (41).…”

Improvement of mortality prediction accuracy in critically ill patients through combination of SOFA and APACHE II score with markers of stress haematopoiesis

“…This condition is manifested by presence of nucleated red blood cells (erythroblasts, NRBC) and immature granulocytes (IG) in the peripheral blood. The presence of NRBCs and IGs is associated with bad prognosis 8‐17 and increased mortality in critically ill patients 18‐23 …”

“…The presence of NRBCs and IGs is associated with bad prognosis [8][9][10][11][12][13][14][15][16][17] and increased mortality in critically ill patients. [18][19][20][21][22][23] The aim of our study was to evaluate the diagnostic value of erythroblast and IG numbers as compared with SOFA and APACHE II indices and to propose a model of improved mortality prediction including these parameters in the assessment of critically ill patients.…”

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

“…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.…”