Epidemiology and Prognostic Utility of Cellular Components of Hematological System in Sepsis

Harsha Sinha; Souvik Maitra; Rahul K Anand; Richa Aggarwal; Vimi Rewari; Rajeshwari Subramaniam; Anjan Trikha; Mahesh K Arora; Ravinder K Batra; Renu Saxena; Dalim K Baidya

doi:10.5005/jp-journals-10071-23874

Epidemiology and Prognostic Utility of Cellular Components of Hematological System in Sepsis

Indian J Crit Care Med. 2021 Jun;25(6):660-667. doi: 10.5005/jp-journals-10071-23874.

Affiliations

¹ Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
² Department of Anaesthesiology, Institute of Liver and Biliary Sciences, New Delhi, India; Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
³ Department of Hematopathology, Medanta: The Medicity, Gurugram, Haryana, India; Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.

Abstract

Background: Data are lacking on the role of cellular components of hematological system as biomarkers for prognosis of sepsis. We planned to identify if these parameters measured at admission to ICU and at 72 hours can be useful as prognostic marker in septic critically ill patients.

Materials and methods: In this prospective observational study, 130 adult patients with sepsis were recruited. Various hematological study parameters (total, differential, and absolute leukocyte count, platelet count, platelet distribution width, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio) were noted at day 1 and day 3 of admission. Primary outcome was 28-day mortality, and secondary outcomes were duration of mechanical ventilation, vasopressor requirement, ICU length of stay, and requirement of renal replacement therapy. The variables were compared between two groups and using binary regression model and were evaluated as prognostic markers for 28-day mortality.

Results: Data from n = 129 were analyzed. At day-28, n = 58 (44.96%) patients survived. Baseline and demographic parameters were comparable between survivors and nonsurvivors. Admission Sequential Organ Failure Assessment score was more in nonsurvivors than survivors [8 (6-8) vs 6 (4-8); p = 0.002]. In nonsurvivors, monocyte, lymphocyte, basophil, eosinophil, and platelet count were significantly less at day 1 and lymphocyte, eosinophil, basophil and platelet count were significantly less at day 3. NLR and PLR at day 3 were significantly more in nonsurvivors. On logistic regression analysis, age, thrombocytopenia on day 1, and low eosinophil count on day 3 predicted 28-day mortality (p = 0.006, p = 0.02, and p = 0.04, respectively).

Conclusion: Thrombocytopenia on day 1 and eosinopenia on day 3 may predict 28-day mortality in sepsis.

How to cite this article: Sinha H, Maitra S, Anand RK, Aggarwal R, Rewari V, Subramaniam R, et al. Epidemiology and Prognostic Utility of Cellular Components of Hematological System in Sepsis. Indian J Crit Care Med 2021;25(6):660-667.

Keywords: Critically ill adults; Mortality prediction; Sepsis; Thrombocytopenia.