Eosinopenia is a reliable marker of sepsis on admission to medical intensive care unitsReport as inadecuate




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Critical Care

, 12:R59

First Online: 24 April 2008Received: 28 January 2008Revised: 30 March 2008Accepted: 24 April 2008

Abstract

IntroductionEosinopenia is a cheap and forgotten marker of acute infection that has not been evaluated previously in intensive care units ICUs. The aim of the present study was to test the value of eosinopenia in the diagnosis of sepsis in patients admitted to ICUs.

MethodsA prospective study of consecutive adult patients admitted to a 12-bed medical ICU was performed. Eosinophils were measured at ICU admission. Two intensivists blinded to the eosinophils classified patients as negative or with systemic inflammatory response syndrome SIRS, sepsis, severe sepsis, or septic shock.

ResultsA total of 177 patients were enrolled. In discriminating noninfected negative + SIRS and infected sepsis + severe sepsis + septic shock groups, the area under the receiver operating characteristic curve was 0.89 95% confidence interval CI, 0.83 to 0.94. Eosinophils at <50 cells-mm yielded a sensitivity of 80% 95% CI, 71% to 86%, a specificity of 91% 95% CI, 79% to 96%, a positive likelihood ratio of 9.12 95% CI, 3.9 to 21, and a negative likelihood ratio of 0.2195% CI, 0.15 to 0.31. In discriminating SIRS and infected groups, the area under the receiver operating characteristic curve was 0.84 95% CI, 0.74 to 0.94. Eosinophils at <40 cells-mm yielded a sensitivity of 80% 95% CI, 71% to 86%, a specificity of 80% 95% CI, 55% to 93%, a positive likelihood ratio of 4 95% CI, 1.65 to 9.65, and a negative likelihood ratio of 0.25 95% CI, 0.17 to 0.36.

ConclusionEosinopenia is a good diagnostic marker in distinguishing between noninfection and infection, but is a moderate marker in discriminating between SIRS and infection in newly admitted critically ill patients. Eosinopenia may become a helpful clinical tool in ICU practices.

AbbreviationsCIconfidence interval

CRPC-reactive protein

ICUintensive care unit

ILinterleukin

PCRpolymerase chain reaction

SIRSsystemic inflammatory response syndrome.

Electronic supplementary materialThe online version of this article doi:10.1186-cc6883 contains supplementary material, which is available to authorized users.

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Author: Khalid Abidi - Ibtissam Khoudri - Jihane Belayachi - Naoufel Madani - Aicha Zekraoui - Amine Ali Zeggwagh - Redouane Abouq

Source: https://link.springer.com/







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