Eosinopenia: Is it a good marker of sepsis in comparison to procalcitonin and C-reactive protein levels for patients admitted to a critical care unit in an urban hospital?

Shaaban, Hamid; Daniel, Sunil; Sison, R G; Slim, Jihad; Perez, George

doi:10.1016/j.jcrc.2010.03.002

Cited by 93 publications

(123 citation statements)

References 21 publications

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“…Our results show that esinopenia is a strong predictor of inhospital mortality (p = 0.003) ( Table 6). It has previously been shown in an animal model that esinopenia accompanies the response to acute infection and inflammation [30], independent of adrenal glucocorticosteroids [31], and may be a useful marker of sepsis in patients who are receiving intensive care [32,33]. In AECOPD, the strong prognostic influence of eosinopenia may reflect the severity of the accompanying acute inflammatory response [1].…”

Section: Discussionmentioning

confidence: 99%

Value of the DECAF score in predicting hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease admitted to Zagazig University Hospitals, Egypt

Nafae

Embarak

Gad

2015

Egyptian Journal of Chest Diseases and Tuberculosis

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Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are both common and often fatal. Lack of an accurate prognostic tool that can accurately predict inhospital mortality and help clinicians triaging patients to the appropriate level of care is a challenge. Toward this aim, the Dyspnea, Esinopenia, Consolidation, Acidemia and atrial Fibrillation (DECAF) Score is needed to be assessed against other available scores.Patients and methods: Two hundred patients with primary diagnosis of AECOPD were included. They were subjected to thorough medical history taking, full clinical examination, plain chest X-ray, routine laboratory investigations, ECG, ABG s analysis, assessment of DECAF Score, Acute Physiology and Chronic Health Evaluation (APACHE II) score, COPD and Asthma Physiology Score (CAPS) and CURB-65 score. Inhospital mortality was recorded.Results: Twenty-five (12.5%) patients died in hospital. The DECAF Score showed an excellent discrimination for inhospital mortality (AUROC = 0.83) and performed significantly better for the prediction of inhospital mortality than: APACHE II Score (AUROC = 0.68, DECAF vs APACHE II p = 0.03); and the COPD and Asthma Physiology Score (CAPS) (AUROC = 0.65, p = 0.01). Furthermore, DECAF was a significantly stronger predictor of inhospital mortality than CURB-65 for the subgroup of patients with radiological consolidation (AUROC = 0.87 vs 0.65, p = 0.02).Conclusion: The DECAF Score is a simple and effective clinical tool that can risk stratify hospitalized patients with AECOPD and could therefore help clinicians managing this fatal condition.

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Section: Discussionmentioning

confidence: 99%

Value of the DECAF score in predicting hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease admitted to Zagazig University Hospitals, Egypt

Nafae

Embarak

Gad

2015

Egyptian Journal of Chest Diseases and Tuberculosis

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“…However, while eosinophils are primarily recognized as terminal effectors of allergic responses and of parasite elimination [19,20], a distinct aspect of the body's response to infection or inflammation is also a reduction in the number of circulating eosinophils [21][22][23][24]. The mechanisms underlying this reduction remain to be elucidated; however, this may be partially explained by the release of small but consistent amounts of chemotactic factors into the circulation and eosinophil accumulation at tissue sites, e.g., lymph nodes [21,25].…”

Section: Discussionmentioning

confidence: 99%

Hematological features in adolescents with periodontitis

2011

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The aim of this study was to assess whether adolescent cases of periodontitis present with different hemogram findings than control subjects. This case-control study comprised 87 adolescent cases presenting with clinical attachment loss ≥3 mm in at least two teeth and 73 control subjects. Blood samples were obtained by venipuncture and analyzed in an Abbott Cell-Dyn 3,500 hematology analyzer for values of white blood cells and red blood cells, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red-cell distribution width, platelets, and mean platelet volume. Hematocrit values were obtained using volume fractions read from capillary tubes. The associations between log-transformed hemogram variables with each of the three exposure variables "case status" (yes/no), a "high percent sites with PD ≥4 mm" (yes/no), and a "high percent sites with BOP" (yes/no) were investigated using multivariate linear regression analyses. Periodontitis cases presented with 5% higher values for the mean platelet volume than did controls. Subjects with a high percent sites with probing depth ≥4 mm had eosinophil counts that were on average 27% lower than among subjects with fewer deepened pockets. They also had 7% higher values for the mean platelet volume than did persons with less pocketing. Eosinophil counts and mean platelet volumes may be associated with the parameters of periodontitis in adolescents. While standard hematological testing did not show abnormalities in adolescents with periodontitis compared to healthy controls, eosinophil counts and mean platelet volumes may reflect periodontal inflammation.

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“…Shaaban et al reported that in a total of 68 patients enrolled into a study in a critical care unit, eosinophil cell count, with cut-off of 50 cells/mm 3 , produced a sensitivity of 81%, specificity of 65%, a PPV of 66% an NPV of 80%. 20 Evidence is growing that the neutrophil/lymphocyte count ratio (NLCR) is useful in the prediction of survival in various clinical settings. In the present study of 50 patients with diagnosis of sepsis and 21 patients with no sepsis NLR ≥5 was used for the diagnosis of patients with sepsis in accordance with the study of Gurol et al, who reported that an NLR value ≥5 may be a more convenient marker than CRP, due to its improved ability to detect bacterial infections at lower cost.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of eosinophil count and neutrophil-lymphocyte count ratio versus C-reactive protein levels in patients with sepsis

Khajuria¹,

Jamwal²,

Gupta³

et al. 2017

Int J Res Med Sci

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Background: One major problem encountered in the intensive care unit is differentiating the inflammatory response from an infective process. Clinical and standard laboratory tests are not very helpful because most critically ill patients develop some degree of inflammatory response, whether or not they have sepsis. Numerous biomarkers have been evaluated to predict mortality in critically ill patients, although none have proved entirely useful. Objective of the study was to evaluate eosinophil count and neutrophil-lymphocyte count ratio with C-reactive protein levels in patients with sepsis.Methods: 71 patients >18 years of age of either sex with a diagnosis of sepsis were enrolled in this one-year observational study. Patients were classified according to the criteria of the American College of Chest Physicians/Society of Critical Care Medicine into sepsis group (n=50) and no sepsis group (n=21). Sepsis group were further divided into subgroups: sepsis (n=19), severe sepsis (n=16) and septic shock (n=15). Absolute eosinophil cell, neutrophil and lymphocyte counts for first 4 consecutive days and then on alternate days up to one week were also noted down. C-reactive protein levels on day 3 were also noted down.Results: In the sepsis group, mean eosinophil count was significantly (p<0.0001) low, mean neutrophil/lymphocyte count ratio was significantly (p<0.0001) high, mean CRP count was significantly (p=0.019) more as compared to that of no sepsis group. Among 16 mortalities, significant (p<0.05) decrease was noted in mean eosinophil count from day 3 onwards in patients of sepsis and septic shock subgroups. Mean N/L ratio showed no significant difference in patients of sepsis, severe sepsis or septic shock. Mean CRP count showed significant (p<0.05) increase in severe sepsis patients and mean Apache II score showed significant (p<0.05) deterioration in patients of septic shock.Conclusions: Neutrophil/lymphocyte count ratio (NLCR) and absolute eosinophil count (AEC) came out as better independent biomarker of sepsis in critically ill patients with infection admitted in intensive care unit. Diagnostic performance was better in these two diagnostic markers as compared to CRP marker. NLCR presented with sensitivity of 89.58%, AEC with 82.35% and CRP with 80.77%. Outcomes of NLCR and AEC were quick, easy and economical in establishing diagnosis of sepsis.

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Eosinopenia: Is it a good marker of sepsis in comparison to procalcitonin and C-reactive protein levels for patients admitted to a critical care unit in an urban hospital?

Cited by 93 publications

References 21 publications

Value of the DECAF score in predicting hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease admitted to Zagazig University Hospitals, Egypt

Value of the DECAF score in predicting hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease admitted to Zagazig University Hospitals, Egypt

Hematological features in adolescents with periodontitis

Evaluation of eosinophil count and neutrophil-lymphocyte count ratio versus C-reactive protein levels in patients with sepsis

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