Evaluation of use of Volume Conductivity Scatter Parameters as Early Indicator of Sepsis in Elderly Patients: A Hospital Based Case Control Study

Abstract

Introduction: Sepsis in elderly patients is a critical clinical issue due to high rates of morbidity and mortality. The modern age cell counters precisely measure volume, size and internal structure of the cell thereby assessing increase in volume and cytoplasmic granularity of leukocytes as seen in cases of sepsis. The present study was done to evaluate the use of Volume Conductivity Scatter (VCS) parameters as early indicators of sepsis in elderly patients and to overcome the shortcomings of blood culture by using a more precise VCS technology to assess morphologic changes in cell populations in sepsis. Material and Method: The study included 51 patients above the age of 50 years which were divided into 2 groups Group 1, patients with localised infection (n= 39) and Group 2 with systemic infection (n=12). Group 3 included 30 controls without any signs of infection and with total leucocyte count and differential counts within normal limits. Coulter LH 750 cellular analysis system was used. Result: Significant increase in both mean neutrophil volume (MNV) and mean monocyte volume (MMV) was reported among the patients with sepsis as compared to localized infections or control. With a cut off of 145 and 170 for MNV and MMV respectively, a sensitivity of 96% and 91.4% was obtained in predicting sepsis. Conclusion: Both MNV and MMV have the potential to be used as early indicators of acute bacterial infections.