The Diagnostic Value of Automated Neutrophil and Monocyte Parameters in Early Recognition of Sepsis

Taruna Bansal; Sonal Yadav; Garima Rakheja; Vijay Kumar

doi:10.21276/apalm.3552

Authors

Taruna Bansal Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
Sonal Yadav Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
Garima Rakheja Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
Vijay Kumar Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India

DOI:

https://doi.org/10.21276/apalm.3552

Keywords:

sepsis, cell population data, NEU-X, NEU-Y, MON-X, MON-Y

Abstract

Background: Sepsis is a medical emergency. Treatment for sepsis is effective only if started early, and a critical lapse of time may be detrimental. The existing blood biomarkers for sepsis, like CRP and Procalcitonin, suffer from cost-ineffectiveness and an additional sample to be handled. The Leukocyte Cell Population Data (CPD) include NEU-X, NEU-Y, MON-X, and MON-Y. NEU-X measures the structural complexity of neutrophils by sideward scatter (SSC), while NEU-Y measures the DNA and RNA content by sideward fluorescence light. Our study aimed to evaluate the utility and significance of NEU-X and NEU-Y in the early diagnosis of sepsis.

Methods: It was a prospective, observational study done over a period of one month at a tertiary care hospital, which included 300 participants admitted in the ICU: 150 adults with suspected sepsis and 150 healthy controls. Blood samples were collected in EDTA vials and run on a Sysmex XN-1000 automated hematology analyser for CBC (complete blood counts) and values of NEU-X, NEU-Y, MON-X, and MON-Y parameters.

Results: The median value of NEU-X, NEU-Y, and MON-Y demonstrated a significant p-value of <0.0001 between cases and controls. NEU-X had a sensitivity of 79.33% and specificity of 91.33% at a cut-off of >339, while NEU-Y exhibited sensitivity and specificity of 93.33% each at a cut-off of >727. MON-Y and MON-X had a cut-off value of ≤90.3 and ≤118.9, respectively.

Conclusion: The leukocyte CPD parameters-NEU-X, NEU-Y, and MON-Y-represent a promising set of data and can be helpful in the early diagnosis of sepsis.

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