The clinical value of hematological neutrophil and monocyte parameters in the diagnosis and identification of sepsis

BACKGROUND: Sepsis is a life-threatening condition of organ dysfunction caused by the host’s disordered immune response to infection. It has a high fatality rate and seriously endangers human health. Rapid and accurate treatment plays an important role in the reduction of septic mortality. This study aimed to investigate the clinical value of hematological parameters neutrophil (NEU)-X, NEU-Y, monocyte (MON)-X, and MON-Y in sepsis, and compare their values with that of with C-reactive protein (CRP). METHODS: We collected dipotassium ethylenediaminetetraacetic acid (EDTA-K2) anticoagulant blood samples from a total of 267 patients with positive bacterial culture and 260 healthy physical check-up patients. Participants were divided into three groups: a normal control group (n=260), bacterial infection group (n=196), and a sepsis group (n=71). RESULTS: Median values of NEU-X, NEU-Y, MON-X, MON-Y, and CRP in the sepsis group were significantly higher than those in the control group and the bacterial infection group (P<0.0001). The area under the receiver operating characteristic curve (AUC) of NEU-X, NEU-Y, MON-X, MON-Y, and CRP for the diagnosis of sepsis was 0.751 (sensitivity 76.1%, specificity 58.2%), 0.877 (87.3%, 72.1%), 0.791 (77.6%, 65.9%), 0.695 (71.6%, 51.4%), and 0.790 (72.5%, 70.2%), respectively. In addition, blood smear examination results showed that NEU-X value was positively correlated with the degree of toxic granulation in neutrophils. CONCLUSIONS: The parameters NEU-X, NEU-Y, and MON-X can be used as indicators for the differential diagnosis of sepsis with comparable diagnostic efficacy to CRP. Compared to CRP, these hematological parameters are easier to obtain, more convenient, and have economic benefits.