Validation of Immature Granulocyte as a Predictor for the 28-Day Mortality in Patients with Severe Sepsis and Septic Shock
Journal of the Korean Society of Emergency Medicine
; : 167-173, 2014.
Article
de Ko
| WPRIM
| ID: wpr-114588
Bibliothèque responsable:
WPRO
ABSTRACT
PURPOSE: Recently, several studies for immature granulocyte proportion (IG%) in patients with sepsis have revealed its association with diagnosis and prognosis of patients with sepsis. In this study, we enrolled patients with severe sepsis and septic shock and compared IG% with other biologic markers as a predictor of 28-day mortality. METHODS: This was a retrospective study for patients with severe sepsis and septic shock who were admitted to the emergency department of a tertiary care hospital for four-months. The IG% measured using Sysmex XE-2100 and other inflammatory markers, including C-reactive protein, lactate, and procalcitonin were evaluated and compared for 28-day mortality. RESULTS: A total of 85 patients with septic shock and 45 patients with severe sepsis were enrolled. In the non-survivors group (n=32, 24.6%), APACHE II score (p=0.017), use of continuous renal replacement therapy (CRRT) (p=0.002), and septic shock (p=0.009) were statistically higher compared with thesurvivors group. APACHE II score (Odd ratio [OR] 1.099, p=0.008) and IG% (> or =0.5%) (OR 3.568, p=0.036) predicted the 28-day mortality independently after adjusting SOFA score, septic shock,disseminated intravascular coagulopathy, use of CRRT, and gender. However, IG (> or =0.5%) had low specificity of 33.7% and positive predictive value (PPV) of 30.1% for 28-day mortality. CONCLUSION: IG% could be a useful biologic marker for prediction of 28-day mortality in patients with severe sepsis or septic shock. However, the limitation of low specificity and PPV must be considered in clinical use.
Mots clés
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Pronostic
/
Choc septique
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Soins de santé tertiaires
/
Protéine C-réactive
/
Marqueurs biologiques
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Études rétrospectives
/
Mortalité
/
Sensibilité et spécificité
/
Traitement substitutif de l'insuffisance rénale
/
Sepsie
Type d'étude:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites du sujet:
Humans
langue:
Ko
Texte intégral:
Journal of the Korean Society of Emergency Medicine
Année:
2014
Type:
Article