Implementation of Complementary Model using Optimal Combination of Hematological Parameters for Sepsis Screening in Patients with Fever.

The early detection and timely treatment are the most important factors for improving the outcome of patients with sepsis. Sepsis-related clinical score, such as SIRS, SOFA and LODS, were defined to identify patients with suspected infection and to predict severity and mortality. A few hematological parameters associated with organ dysfunction and infection were included in the score although various clinical pathology parameters (hematology, serum chemistry and plasma coagulation) in blood sample have been found to be associated with outcome in patients with sepsis. The investigation of the parameters facilitates the implementation of a complementary model for screening sepsis to existing sepsis clinical criteria and other laboratory signs. In this study, statistical analysis on the multiple clinical pathology parameters obtained from two groups, patients with sepsis and patients with fever, was performed and the complementary model was elaborated by stepwise parameter selection and machine learning. The complementary model showed statistically better performance (AUC 0.86 vs. 0.74-0.51) than models built up with specific hematology parameters involved in each existing sepsis-related clinical score. Our study presents the complementary model based on the optimal combination of hematological parameters for sepsis screening in patients with fever.

[Evaluation of the Abbott Cell-Dyn Sapphire hematology analyzer].

BACKGROUND: The performance of Cell-Dyn Sapphire (Abbott Diagnostic, USA) was compared to the Bayer Advia 2120 (Bayer Diagnostics, USA), Sysmex XE-2100 (Sysmex Corporation, Japan), and reference microscopy. METHODS: Three hundred samples for routine CBC and WBC differentials were randomly chosen for a comparison analysis. The Cell-Dyn Sapphire system was evaluated according to the linearity, imprecision, inter-instrument correlations, and white blood cell differential. RESULTS: The CBC parameters (WBC, RBC, hemoglobin and platelet) showed a significant linearity with correlation coefficients greater than 0.99 (P<0.0001). Coefficients of variation (CV) for within-run and differential count of WBC were less than 5% except for Total CV for monocytes, eosinophils, and basophils and within-run CV for low valued eosinophils. The correlation coefficients with manual count were lower in monocytes, eosinophils, and basophils than in neutrophils and lymphocytes. The correlation with other hematology anlayzers was significant exclusive of basophils. CONCLUSIONS: These results demonstrate that the Cell-Dyn Sapphire has a good linearity, an acceptable reproducibility, a minimal carryover, and a comparable performance with the sysmex XE-2100 and Advia 2120.