Extended Hematological Parameters and Short-Term Mortality in Sepsis Patients: A Retrospective Study.

Background/

Objectives

Sepsis has a high mortality rate, with septic shock exceeding 50%. The most common score for diagnosis and prognosis in sepsis is the Sepsis-related Organ Failure Assessment (SOFA). This study aimed to identify hematological parameters for the prediction of intensive care unit (ICU) mortality.

Methods

This study collected demographic and clinical data from sepsis patients, including age, sex, infection site, length of stay, the SOFA, and ICU mortality. The standard laboratory panel included, among others, complete blood count with differential and reticulocyte panel. Intergroup differences were analyzed using Student's t-test, Mann-Whitney U test, Pearson's χ2, and Fisher's test where applicable. The AUROC was used for evaluating the predictive value of hematological parameters. Multiple logistic regression was performed to exclude the impact of potential confounding factors.

Results

This study analyzed data from 190 sepsis patients hospitalized in the ICU, excluding patients with other conditions significantly affecting mortality. The median age was 65.0 (IQR 51.0-71.0) years. The sexes were almost perfectly balanced. The sites of infection were mostly the abdominal cavity, lungs, and urinary tract. The short-term mortality rate was 30%, with higher SOFA scores and significant differences in leukocyte, platelet, and erythrocyte parameters between survivors and non-survivors. The percentage of nucleated red blood cells (NRBCs) showed the highest AUROC.

Conclusions

The only reliable hematological parameter for predicting ICU mortality in sepsis patients may be the percentage of NRBCs. The presence of NRBCs in a blood smear is linked to a worse prognosis.