[Relevance of eosinopenia as marker of sepsis in the Emergency Department]

Abstract

Background: Several studies in internal medicine departments and in intensive care units have shown the interest of eosinopenia in the diagnosis of infected patients. The aim of the present study was to test the value of this marker in the Emergency Department (ED), either alone or associated with other common sepsis markers.

Methods: We report on a retrospective and monocentric study. We reviewed the complete blood count (CBC) of all patients visiting the ED during one-week duration (in February 2014). Every element of the CBC and other inflammation markers (such as CRP) were analyzed.

Results: During the week of our study, 725 patients had a CBC (33 exclusions) and 692 patients were included for analysis. The median age was 59 years (IQR: 16-100). One hundred and twenty-five patients (18.1%) had a sepsis. The ROC curve demonstrated a cut off level of 10/mm³ eosinophils for which the specificity for sepsis was 91%. The association of eosinopenia (< 10/mm³) and white blood cells (WBC) or CRP elevation also showed a good specificity in patients with sepsis.

Conclusion: In the ED, with a "simple" CBC, a profound eosinopenia appears to be very specific for sepsis, alone or in association with other markers of inflammation. Eosinopenia may become a helpful tool in our daily practice in the ED. Further studies are needed to further evaluate this marker.

Keywords: Complete blood count; Emergency department; Eosinopenia; Numération formule sanguine; Sepsis; Urgences; Éosinopénie.