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

Abstract 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...

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Autores principales: R. J. Dinsdale, A. Devi, P. Hampson, C. M. Wearn, A. L. Bamford, J. Hazeldine, J. Bishop, S. Ahmed, C. Watson, J. M. Lord, N. Moiemen, P. Harrison
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Publicado: Nature Portfolio 2017
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spelling oai:doaj.org-article:f0ffa1f9c8994ad48ad4097ed7bce2782021-12-02T11:52:41ZChanges in novel haematological parameters following thermal injury: A prospective observational cohort study10.1038/s41598-017-03222-w2045-2322https://doaj.org/article/f0ffa1f9c8994ad48ad4097ed7bce2782017-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-03222-whttps://doaj.org/toc/2045-2322Abstract 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.R. J. DinsdaleA. DeviP. HampsonC. M. WearnA. L. BamfordJ. HazeldineJ. BishopS. AhmedC. WatsonJ. M. LordN. MoiemenP. HarrisonNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-11 (2017)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
R. J. Dinsdale
A. Devi
P. Hampson
C. M. Wearn
A. L. Bamford
J. Hazeldine
J. Bishop
S. Ahmed
C. Watson
J. M. Lord
N. Moiemen
P. Harrison
Changes in novel haematological parameters following thermal injury: A prospective observational cohort study
description Abstract 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.
format article
author R. J. Dinsdale
A. Devi
P. Hampson
C. M. Wearn
A. L. Bamford
J. Hazeldine
J. Bishop
S. Ahmed
C. Watson
J. M. Lord
N. Moiemen
P. Harrison
author_facet R. J. Dinsdale
A. Devi
P. Hampson
C. M. Wearn
A. L. Bamford
J. Hazeldine
J. Bishop
S. Ahmed
C. Watson
J. M. Lord
N. Moiemen
P. Harrison
author_sort R. J. Dinsdale
title 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_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_sort changes in novel haematological parameters following thermal injury: a prospective observational cohort study
publisher Nature Portfolio
publishDate 2017
url https://doaj.org/article/f0ffa1f9c8994ad48ad4097ed7bce278
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