Improved Diagnostic and Prognostic Power of Combined Delta Neutrophil Index and Mean Platelet Volume in Pediatric Sepsis
Nam, M.; Son, B.Hei.; Seo, J.Eun.; Kim, I.Ry.; Park, C.Kyoung.; Kim, H.Kyung.
Annals of Clinical and Laboratory Science 48(2): 223-230
2018
ISSN/ISBN: 0091-7370 PMID: 29678851 Document Number: 696350
This study aims to evaluate the diagnostic and prognostic significance of white blood cell (WBC) and platelet parameters measured by automated hematology analyzers in pediatric sepsis. The study included 232 pediatric patients whose C-reactive protein test had been requested for evaluation of infection or inflammation at a pediatric tertiary hospital. The patients were allocated to control, systemic inflammatory response syndrome (SIRS) without infection, and sepsis groups. An ADVIA 2120i hematology system was used to measure the delta neutrophil index (DN) and platelet parameters including platelet count, mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and immature platelet fraction (IPF). A Coulter LH750 hematology analyzer was used to measure the neutrophil volume distribution width (NDW) and monocyte volume distribution width (MDW). The levels of DN, NDW, MDW, MPV, and IPF each gradually increased from the control to SIRS without infection to sepsis. For sepsis, the highest area under the curve (AUC) value was observed for DN. In addition, NDW, MDW, platelet count, PCT, and IPF showed higher AUC values than C-reactive protein. WBC, DN, NDW, MDW, MPV, PDW, PMDW, and IPF were valuable markers for predicting mortality. Of note, the combination of DN and MPV showed a significantly higher prognostic value when compared with individual DN or MPV. Therefore, considering that DN and MPV are each included in a routine complete blood cell count, their combination can be an alternative parameter to assist in achieving a fast and accurate diagnosis and predict the prognosis of sepsis in pediatric patients.