1
|
Urrechaga E, Bóveda O, Aguirre U. Improvement in detecting sepsis using leukocyte cell population data (CPD). ACTA ACUST UNITED AC 2018; 57:918-926. [DOI: 10.1515/cclm-2018-0979] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 11/20/2018] [Indexed: 01/03/2023]
Abstract
Abstract
Background
The cell population data (CPD) parameters reported by XN analyzers (Sysmex Corporation, Kobe, Japan) reflect the size and internal structure of leukocytes. We explored whether CPD values could contribute to recognize those patients with fever at risk to develop sepsis. A profile of sepsis was developed combining CPD parameters and other markers.
Methods
We recruited 295 patients at the onset of fever, with infection confirmed by positive cultures. We studied the diagnostic performance of the CPD parameters in the differential diagnosis of sepsis vs. non-systemic bacterial infection using receiver operating characteristic (ROC) curve analysis. Additionally, the K-means unsupervised clustering method was applied. Once the clusters had been defined, the relationship between them and the CPD parameter values was assessed with the non-parametric Wilcoxon test. Lastly, the relationship between the clusters obtained and the categorical variables was examined with the χ2-test (or Fisher’s exact test).
Results
ROC analysis demonstrated that NE-FSL, NE-WY, NE-WZ and MO-WZ had areas under the curve (AUCs) >0.700 for predicting sepsis. Using the K-means clustering algorithm, 80 patients (66.67%) were assigned to Cluster 1 and the others to Cluster 2. Out of 80 of patients in Cluster 1, 45 (56.25%) presented a PCT value ≥2 ng/mL, whereas almost 80% of Cluster 2 patients had a PCT <2 ng/mL. Cluster 1 was characterized by high NE-SFL, NE-WY, MO-X, MO-WX and MO-Z values (p<0.05).
Conclusions
CPD related to monocyte complexity and neutrophil activation were found to be significant, with high values suggesting sepsis.
Collapse
Affiliation(s)
- Eloísa Urrechaga
- CORE Laboratory , Hospital Galdakao – Usansolo , Galdakao, Vizcaya , Spain
| | - Oihane Bóveda
- CORE Laboratory , Hospital Galdakao – Usansolo , Galdakao, Vizcaya , Spain
| | - Urko Aguirre
- Research Unit, REDISSEC, Health Services Research on Chronic Patients Network , Hospital Galdakao – Usansolo , Galdakao, Vizcaya , Spain
| |
Collapse
|