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

Abstract

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.

Prognostic Value of Platelet to Lymphocyte Ratio in Sepsis: A Systematic Review and Meta-analysis

“…Sepsis is a complicated condition caused by a malfunction of the host's immune response to infection, which results in an uncontrollable inflammatory response and immunosuppression [ 1 ]. It develops as a result of infections acquired both in the community and in the healthcare system, particularly in intensive care units (ICUs), where it is the leading cause of death, responsible for more than half of all ICU deaths.…”

“…It develops as a result of infections acquired both in the community and in the healthcare system, particularly in intensive care units (ICUs), where it is the leading cause of death, responsible for more than half of all ICU deaths. Consequently, sepsis is seen as a global health problem with significant economic effects [ 1 , 2 ]. As a result, identifying prognostic and diagnostic biomarkers is critical in order to avoid adverse outcomes and reduce mortality by initiating treatment before irreversible damage occurs.…”

“…As a result, many efforts have been made to find a viable biomarker for screening sepsis patients who are at a high risk of death. Among all the sepsis biomarkers studied, complete blood count (CBC) metrics, including the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), could be valuable tools [ 1 ]. Undoubtedly, CBC has many advantages: (i) it is inexpensive, (ii) it has a quick turn-around time (TAT), (iii) it is accessible in all health centers, (iv) it is simple to perform, (v) clinicians regularly request CBC as part of patient management, and (vi) it is the most commonly ordered laboratory test in all medical settings, from the ICU to the emergency department (ED) [ 1 ].…”

“…Among all the sepsis biomarkers studied, complete blood count (CBC) metrics, including the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), could be valuable tools [ 1 ]. Undoubtedly, CBC has many advantages: (i) it is inexpensive, (ii) it has a quick turn-around time (TAT), (iii) it is accessible in all health centers, (iv) it is simple to perform, (v) clinicians regularly request CBC as part of patient management, and (vi) it is the most commonly ordered laboratory test in all medical settings, from the ICU to the emergency department (ED) [ 1 ]. A recent meta-analysis showed that nonsurvivors had significantly higher NLR levels than survivors (random effect model: SMD = 1.18, 95% CI = 0.42–1.94).…”

A retrospective study of age‐defined hematologic inflammatory markers related to pediatric COVID‐19 diagnosis

“… 5 , 6 , 7 Calculated ratios of CBC parameters have been proposed as biomarkers for diagnosis, classification, and progression in inflammatory diseases. 8 , 9 …”