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Changes in novel haematological parameters following thermal injury: A prospective observational cohort study

The mortality caused by sepsis is high following thermal injury. Diagnosis is difficult due to the ongoing systemic inflammatory response. Previous studies suggest that cellular parameters may show promise as diagnostic markers of sepsis. The aim of this study was to evaluate the effect of thermal i...

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Autores principales: Dinsdale, R. J., Devi, A., Hampson, P., Wearn, C. M., Bamford, A. L., Hazeldine, J., Bishop, J., Ahmed, S., Watson, C., Lord, J. M., Moiemen, N., Harrison, P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5468303/
https://www.ncbi.nlm.nih.gov/pubmed/28607467
http://dx.doi.org/10.1038/s41598-017-03222-w
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author Dinsdale, R. J.
Devi, A.
Hampson, P.
Wearn, C. M.
Bamford, A. L.
Hazeldine, J.
Bishop, J.
Ahmed, S.
Watson, C.
Lord, J. M.
Moiemen, N.
Harrison, P.
author_facet Dinsdale, R. J.
Devi, A.
Hampson, P.
Wearn, C. M.
Bamford, A. L.
Hazeldine, J.
Bishop, J.
Ahmed, S.
Watson, C.
Lord, J. M.
Moiemen, N.
Harrison, P.
author_sort Dinsdale, R. J.
collection PubMed
description The mortality caused by sepsis is high following thermal injury. Diagnosis is difficult due to the ongoing systemic inflammatory response. Previous studies suggest that cellular parameters may show promise as diagnostic markers of sepsis. The aim of this study was to evaluate the effect of thermal injury on novel haematological parameters and to study their association with clinical outcomes. Haematological analysis was performed using a Sysmex XN-1000 analyser on blood samples acquired on the day of the thermal injury to 12 months post-injury in 39 patients (15–95% TBSA). Platelet counts had a nadir at day 3 followed by a rebound thrombocytosis at day 21, with nadir values significantly lower in septic patients. Measurements of extended neutrophil parameters (NEUT-Y and NEUT-RI) demonstrated that septic patients had significantly higher levels of neutrophil nucleic acid content. A combination of platelet impedance count (PLT-I) and NEUT-Y at day 3 post-injury exhibited good discriminatory power for the identifying septic patients (AUROC = 0.915, 95% CI [0.827, 1.000]). Importantly, the model had improved performance when adjusted for mortality with an AUROC of 0.974 (0.931, 1.000). A combination of PLT-I and NEUT-Y show potential for the early diagnosis of sepsis post-burn injury. Importantly, these tests can be performed rapidly and require a small volume of whole blood highlighting their potential utility in clinical practice.
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spelling pubmed-54683032017-06-14 Changes in novel haematological parameters following thermal injury: A prospective observational cohort study Dinsdale, R. J. Devi, A. Hampson, P. Wearn, C. M. Bamford, A. L. Hazeldine, J. Bishop, J. Ahmed, S. Watson, C. Lord, J. M. Moiemen, N. Harrison, P. Sci Rep Article The mortality caused by sepsis is high following thermal injury. Diagnosis is difficult due to the ongoing systemic inflammatory response. Previous studies suggest that cellular parameters may show promise as diagnostic markers of sepsis. The aim of this study was to evaluate the effect of thermal injury on novel haematological parameters and to study their association with clinical outcomes. Haematological analysis was performed using a Sysmex XN-1000 analyser on blood samples acquired on the day of the thermal injury to 12 months post-injury in 39 patients (15–95% TBSA). Platelet counts had a nadir at day 3 followed by a rebound thrombocytosis at day 21, with nadir values significantly lower in septic patients. Measurements of extended neutrophil parameters (NEUT-Y and NEUT-RI) demonstrated that septic patients had significantly higher levels of neutrophil nucleic acid content. A combination of platelet impedance count (PLT-I) and NEUT-Y at day 3 post-injury exhibited good discriminatory power for the identifying septic patients (AUROC = 0.915, 95% CI [0.827, 1.000]). Importantly, the model had improved performance when adjusted for mortality with an AUROC of 0.974 (0.931, 1.000). A combination of PLT-I and NEUT-Y show potential for the early diagnosis of sepsis post-burn injury. Importantly, these tests can be performed rapidly and require a small volume of whole blood highlighting their potential utility in clinical practice. Nature Publishing Group UK 2017-06-12 /pmc/articles/PMC5468303/ /pubmed/28607467 http://dx.doi.org/10.1038/s41598-017-03222-w Text en © The Author(s) 2017 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Dinsdale, R. J.
Devi, A.
Hampson, P.
Wearn, C. M.
Bamford, A. L.
Hazeldine, J.
Bishop, J.
Ahmed, S.
Watson, C.
Lord, J. M.
Moiemen, N.
Harrison, P.
Changes in novel haematological parameters following thermal injury: A prospective observational cohort study
title Changes in novel haematological parameters following thermal injury: A prospective observational cohort study
title_full Changes in novel haematological parameters following thermal injury: A prospective observational cohort study
title_fullStr Changes in novel haematological parameters following thermal injury: A prospective observational cohort study
title_full_unstemmed Changes in novel haematological parameters following thermal injury: A prospective observational cohort study
title_short Changes in novel haematological parameters following thermal injury: A prospective observational cohort study
title_sort changes in novel haematological parameters following thermal injury: a prospective observational cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5468303/
https://www.ncbi.nlm.nih.gov/pubmed/28607467
http://dx.doi.org/10.1038/s41598-017-03222-w
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