The superiority of 72 h leukocyte descent over CRP for mortality prediction in patients with sepsis
| Autor: | Omri Ritter, Dana Shalmon, Ilana Goldiner, Tal Levinson, Ori Rogowski, Shlomo Berliner, Ahuva Meilik, Itzhak Shapira, Ronen Shteinvil, Tomer Ziv-Baran, Eli Sprecher, Shani Shenhar-Tsarfaty, Asaf Wasserman, Ilan Goldberg |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Neutrophils Lymphocyte Clinical Biochemistry Inflammation Biochemistry Sepsis 03 medical and health sciences Leukocyte Count 0302 clinical medicine White blood cell Daily practice Internal medicine medicine Humans In patient Mortality prediction Lymphocytes business.industry Biochemistry (medical) General Medicine medicine.disease 030104 developmental biology medicine.anatomical_structure C-Reactive Protein 030220 oncology & carcinogenesis Cohort medicine.symptom business Biomarkers |
| Zdroj: | Clinica chimica acta; international journal of clinical chemistry. 514 |
| ISSN: | 1873-3492 |
| Popis: | Detection of an eventful course in the early days of sepsis treatment is clinically relevant. The white blood cell count (WBCC) and C-reactive protein (CRP) are used in daily practice to monitor the intensity of the inflammatory response associated with sepsis. It is not entirely clear which of the two might better discriminate the outcomes of patients with sepsis.30-day mortality was assessed in a cohort of patients who were hospitalized with sepsis in the departments of Internal Medicine in a tertiary medical center. Admission and 72-hour time points were analyzed to discriminate between patients with increased versus decreased 30 days mortality risk.The study included 195 patients. Higher 72 h CRP, WBCC, neutrophil counts and neutrophils to lymphocyte ratio were associated with increased mortality (p 0.02). Baseline WBCC and CRP failed to discriminate between patients who died and those who survived (AUC = 0.551, 0.479). In multivariate analysis of the 72 h tests, higher WBCC count (OR = 1.12, 95%CI 1.05-1.20, p = 0.001), was associated with increased mortality whereas CRP was not (OR = 1.004, 95%CI 0.998-1.01, p = 0.146).Patients who presented a 72-hour leukocyte descent had a better outcome and in this regard, WBCC was superior to 72-hour CRP in predicting 30 days mortality. |
| Databáze: | OpenAIRE |
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