A Secondary Retrospective Analysis of the Predictive Value of Neutrophil-Reactive Intensity (NEUT-RI) in Septic and Non-Septic Patients in Intensive Care

Paolo Formenti; Letizia Isidori; Stefano Pastori; Vincenzo Roccaforte; Elena Alessandra Mantovani; Massimiliano Iezzi; Alessandro Menozzi; Rossella Panella; Andrea Galimberti; Giovanni Brenna; Michele Umbrello; Angelo Pezzi; Francesco Vetrone; Giovanni Sabbatini; Miriam Gotti

doi:10.3390/diagnostics14080821

A Secondary Retrospective Analysis of the Predictive Value of Neutrophil-Reactive Intensity (NEUT-RI) in Septic and Non-Septic Patients in Intensive Care

Diagnostics (Basel). 2024 Apr 16;14(8):821. doi: 10.3390/diagnostics14080821.

Authors

Affiliations

¹ S.C. Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milano, Ospedale Bassini, 20097 Cinisello Balsamo, Italy.
² S.C. Analisi Chimico Cliniche e Microbiologiche, ASST Nord Milano, Ospedale Bassini, 20097 Cinisello Balsamo, Italy.
³ School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milano, Italy.
⁴ Department of Intensive Care, New Hospital of Legnano (Ospedale Nuovo di Legnano), 20025 Legnano, Italy.

Abstract

Background: Effective identification and management in the early stages of sepsis are critical for achieving positive outcomes. In this context, neutrophil-reactive intensity (NEUT-RI) emerges as a promising and easily interpretable parameter. This study aimed to assess the predictive value of NEUT-RI in diagnosing sepsis and to evaluate its prognostic significance in distinguishing 28-day mortality outcomes.

Materials: This study is a secondary, retrospective, observational analysis. Clinical data upon ICU admission were collected. We enrolled septic patients and a control group of critically ill patients without sepsis criteria. The patients were divided into subgroups based on renal function for biomarker evaluation with 28-day outcomes reported for septic and non-septic patients.

Results: A total of 200 patients were included in this study. A significant difference between the "septic" and "non-septic" groups was detected in the NEUT-RI plasma concentration (53.80 [49.65-59.05] vs. 48.00 [46.00-49.90] FI, p < 0.001, respectively). NEUT-RI and procalcitonin (PCT) distinguished between not complicated sepsis and septic shock (PCT 1.71 [0.42-12.09] vs. 32.59 [8.83-100.00], <0.001 and NEUT-RI 51.50 [47.80-56.30] vs. 56.20 [52.30-61.92], p = 0.005). NEUT-RI, PCT, and CRP values were significantly different in patients with "renal failure". NEUT-RI and PCT at admission in the ICU in the septic group were higher in patients who died (58.80 [53.85-73.10] vs. 53.05 [48.90-57.22], p = 0.005 and 39.56 [17.39-83.72] vs. 3.22 [0.59-32.32], p = 0.002, respectively). Both NEUT-RI and PCT showed a high negative predictive value and low positive predictive value.

Conclusions: The inflammatory biomarkers assessed in this study offer valuable support in the early diagnosis of sepsis and could have a possible role in anticipating the outcome. NEUT-RI elevation appears particularly promising for early sepsis detection and severity discrimination upon admission.

Keywords: C-reactive protein; neutrophil reactivity (NEUT-RI); procalcitonin; sepsis.

Grants and funding

This research received no external funding.