The Importance of Haemogram Parameters in the Diagnosis and Prognosis of Septic Patients

Abstract

Sepsis represents a severe pathology that requires both rapid and precise positive and differential diagnosis to identify patients who need immediate antimicrobial therapy. Monitoring septic patients’ outcome leads to prolonged hospitalisation and antibacterial therapy, often accompanied by substantial side effects, complications and a high mortality risk.Septic patients present with complex pathophysiological and immunological disorders and with a predominance of pro-inflammatory or anti-inflammatory mediators which are heterogeneous with respect to the infectious focus, the aetiology of sepsis or patients’ immune status or comorbidities. Previous studies performed have analysed inflammatory biomarkers, but a test or combinations of tests that can quickly and precisely establish a diagnosis or prognosis of septic patients has yet to be discovered. Recent research has focused on re-analysing older accessible parameters found in the complete blood count to determine the sensitivity, specificity, positive and negative predictive values for the diagnosis and prognosis of sepsis.The neutrophil/lymphocyte count ratio (NLCR), mean platelet volume (MPV) and red blood cells distribution width (RDW) are haemogram indicators which have been evaluated and which are of proven use in septic patients’ management.

The effectiveness of neutrophil to lymphocyte ratio in prediction of medical treatment failure for tubo‐ovarian abscess

“…Up to now, the importance of NLR is related to the inflammatory process of antimicrobial defense. This process includes an increased number of neutrophils but decreased number of lymphocytes as a result of the redistribution of lymphocytes in the lymphatic system with increased apoptosis …”

“…This process includes an increased number of neutrophils but decreased number of lymphocytes as a result of the redistribution of lymphocytes in the lymphatic system with increased apoptosis. 17 Neutrophil-to-lymphocyte ratio is considered to be superior compared to other biomarkers such as CRP, leukocyte or neutrophil count, in the prediction of bacteremia in patients admitted to emergency or intensive care units. 18 In our study, NLR was significantly higher in the surgical intervention group, however, there was no significant difference between the study groups considering CRP levels.…”

Lymphopenia Predicts Early Mortality in Cancer Patients with Sepsis, A Retrospective Study of Medical Records

“…At the early stage of sepsis, strong systemic in ammatory response stimulates the increase of antiin ammatory response and leads to the negative regulation of lymphocytes [21,25,26]. Immune exhaustion occurs in both cancer and sepsis, while tumor cells expressing pro-apoptotic ligands could induce the destruction of lymphocyte, which might lead to different outcomes between cancer-related and non-cancer-related sepsis [27][28][29][30].…”

Ventriculoperitoneal Shunt Infections in Children: Demographical, Clinical Findings and Evaluation of Thrombocyte Parameters

“…In a study evaluating adult patients with bacterial meningitis and tuberculosis meningitis, platelet count was lower and MPV was higher in patients with bacterial meningitis compared to patients with tuberculous meningitis and healthy control group (32). MPV was found to be high in bacterial bloodstream infections and sepsis and it was shown to be important for prognosis (33)(34)(35). In a study evaluating 196 children diagnosed with acute community-acquired pneumonia, MPV values were found to be higher in the hospitalized patients with severe pneumonia than in outpatients.…”