Role of Selected Hematologic Parameters and C-Reactive Protein as Predictors of Sepsis at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
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Date
2023-05
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Addis Ababa University
Abstract
Background: Sepsis resulted when our body reacts to infection in exaggerated manner. If leftuntreated, multiple organs can fail, septic shock, and even death can occur. Blood culture facilityis highly limited in resource constrained settings like Ethiopia and hence searching for additionalsimple parameters is essential.
Objective: To determine the role of some hematological parameters and C-reactive protein as apredictor of sepsis at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
Methods: In this cross-sectional study, 152 patients with sepsis suspecting were included fromAdult ICU and Emergency of Tikur Anbessa Hospital from April to November 2021. Absoluteneutrophil count (ANC), platelet count, and total WBC count were measured using Beckmancoulter DXH800 hematology analyzer. For calculating the ratio of immature to total neutrophils,peripheral smear was done and neutrophil to lymphocyte ratio was derived from total neutrophiland lymphocyte count. Blood culture was performed in the microbiology department to confirmbacterial infection and CRP was determined semi quantitatively. SPSS version 26 was used fordata entry and analysis. ROC curve analysis and descriptive statistics were used.
Result: Of a total of 152 sepsis suspected cases, 61were culture positive (40.1%). The area underthe curve gives the probability that lower value of Absolute neutrophil count [AUC=0.636 (0.546-0.726) was able to identify sepsis with optimal cutoff value of ≤9.45x109/L having 65.6%sensitivity, 53.8% specificity, 48.8% PPV and 70.0% NPV. NLR was able to identify sepsis with[AUC=0.611(0.518-0.704) and cutoff value of ≤7.41; and CRP [AUC=0.468 (0.373-0.563) withoptimal cutoff value of ≥ 14 mg/dl. The respective sensitivity for WBC, platelet, NLR, CRP, andImmature to total neutrophil ratio were: 62.3%, 60.7%, 60.7%, 52.5%, 54.1% while specificitywas 51.6, 58.2, 59.3, 44.0, and 48.4% respectively.
Conclusion: Monitoring of changes in hematological parameters (ANC, Platelets count, WBC andNLR) and CRP, and combining with other clinical indicators can be useful in early prediction ofsepsis i.e., before the appearance of blood culture results.
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Hematological parameters WBC platelet NLRI:T ratioICUCRPCultureSepsis Ethiopia