Patrick J van der Geest1, Mostafa Mohseni2, Rob Brouwer3, Ben van der Hoven2, Ewout W Steyerberg4, A B Johan Groeneveld2. 1. Department of Intensive Care Medicine, Erasmus Medical Center, Rotterdam, the Netherlands. Electronic address: p.vandergeest@erasmusmc.nl. 2. Department of Intensive Care Medicine, Erasmus Medical Center, Rotterdam, the Netherlands. 3. Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands. 4. Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
Abstract
BACKGROUND: We evaluated the predictive value of immature granulocyte (IG) percentage in comparison with white blood cell counts (WBC) and C-reactive protein (CRP), for infection, its invasiveness, and severity in critically ill patients. METHODS: In 46 consecutive patients, blood samples were collected at the day (0) of a clinical suspicion of microbial infection and at days 1 and 3 thereafter. We defined infections, bloodstream infection, and septic shock within 7 days after enrollment. RESULTS: Of the 46 patients, 31 patients had infection, 15 patients developed bloodstream infection, and 13 patients septic shock. C-reactive protein and IG percentage increased with increasing invasiveness and severity of infection, from day 0 onwards. Receiver operating characteristic analysis to predict infection showed an area under the curve of 0.66 (P=.10) for WBC vs 0.74 (P=.01) for CRP and 0.73 (P=.02) for IG percentage on day 0. Comparing WBC and CRP to WBC and IG percentage results in comparable prediction of microbial infection. Comparing WBC and CRP with WBC, CRP, and IG percentage suggests an additional early value of IG percentage, when not elevated, in ruling out infection. CONCLUSION: Immature granulocyte percentage is a useful marker, as CRP, to predict infection, its invasiveness, and severity, in critically ill patients. However, the IG percentage adds to WBC and CRP in the early exclusion of infection and can be obtained routinely without extra blood sampling or costs.
BACKGROUND: We evaluated the predictive value of immature granulocyte (IG) percentage in comparison with white blood cell counts (WBC) and C-reactive protein (CRP), for infection, its invasiveness, and severity in critically illpatients. METHODS: In 46 consecutive patients, blood samples were collected at the day (0) of a clinical suspicion of microbial infection and at days 1 and 3 thereafter. We defined infections, bloodstream infection, and septic shock within 7 days after enrollment. RESULTS: Of the 46 patients, 31 patients had infection, 15patients developed bloodstream infection, and 13 patientsseptic shock. C-reactive protein and IG percentage increased with increasing invasiveness and severity of infection, from day 0 onwards. Receiver operating characteristic analysis to predict infection showed an area under the curve of 0.66 (P=.10) for WBC vs 0.74 (P=.01) for CRP and 0.73 (P=.02) for IG percentage on day 0. Comparing WBC and CRP to WBC and IG percentage results in comparable prediction of microbial infection. Comparing WBC and CRP with WBC, CRP, and IG percentage suggests an additional early value of IG percentage, when not elevated, in ruling out infection. CONCLUSION: Immature granulocyte percentage is a useful marker, as CRP, to predict infection, its invasiveness, and severity, in critically illpatients. However, the IG percentage adds to WBC and CRP in the early exclusion of infection and can be obtained routinely without extra blood sampling or costs.
Authors: Tracey Anne Mare; David Floyd Treacher; Manu Shankar-Hari; Richard Beale; Sion Marc Lewis; David John Chambers; Kenneth Alun Brown Journal: Crit Care Date: 2015-02-25 Impact factor: 9.097
Authors: Patrick J van der Geest; Mostafa Mohseni; Jo Linssen; Servet Duran; Robert de Jonge; A B Johan Groeneveld Journal: Crit Care Date: 2016-07-07 Impact factor: 9.097