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Updated: Feb 24, 2026
A Data-Driven Approach to Quantifying Immune States in Sepsis
Published on: February 7, 2025
Role of leucocytes cell population data in the early detection of sepsis
Eloísa Urrechaga1, Oihane Bóveda1, Urko Aguirre2
1CORE Laboratory, Hospital Galdakao-Usansolo, Galdakao Vizcaya, Spain.
Insights
Cell population data (CPD) from XN analysers can aid in early sepsis diagnosis. The novel NEMO score, using CPD, offers rapid and reliable risk stratification for sepsis patients.
Area of Science:
- Hematology
- Clinical Diagnostics
- Biomarker Discovery
Background:
- Cell population data (CPD) from automated analyzers provide insights into leukocyte characteristics.
- Early sepsis diagnosis is critical for patient outcomes but can be challenging.
Purpose of the Study:
- To evaluate the clinical utility of CPD parameters as early biomarkers for sepsis detection.
- To develop a sepsis risk stratification score based on relevant CPD.
Main Methods:
- Logistic regression analysis was used to identify predictive CPD parameters in a study group (G1) of controls and sepsis patients.
- A multivariate model identified MO-X and neutrophils fluorescence intensity (NE-SFL) as key predictors.
- A risk stratification scale, the NEMO score, was developed and validated in a separate group (G2).
Main Results:
- MO-X and NE-SFL were the most significant CPD parameters for sepsis prediction.
- The NEMO score effectively stratified patients into mild, moderate, and high sepsis risk groups.
- The NEMO score demonstrated high predictive values (84.8% positive, 96.0% negative) in the validation group.
Conclusions:
- CPD parameters hold potential as valuable biomarkers for the early diagnosis of sepsis.
- The developed NEMO score facilitates rapid and reliable clinical decision-making in sepsis management.
Aims:
The cell population data (CPD) parameters reported by XN analyser (Sysmex, Kobe, Japan) reflect the size and internal structure of leucocytes. We aimed to assess the clinical utility of these parameters as biomarkers for the early diagnosis of sepsis.
Methods:
The study group (G1) included 586 controls (no quantitative or morphological alterations in the complete blood count) and 137 patients diagnosed with sepsis. The reliability of the model was evaluated using a validation group (G2) of 212 controls and 60 patients with sepsis. The optimal cut-off for the diagnosis of sepsis and the OR for CPD were established using a univariate logistic regression. A multivariate logistic regression model was then created. The OR and area under the curve were recorded. A risk stratification scale (neutrophils and monocytes (NEMO)) for diagnosing sepsis was established on the basis of the coefficients of the multivariate model.
Results:
MO-X and neutrophils fluorescence intensity (NE-SFL) were found to be the most relevant of the CPD in predicting sepsis applying multivariate analysis to G1.NEMO score was composed using the above-mentioned CPD and subsequently stratified into three risk groups: mild (≤3), moderate (4≤NEMO≤5) and high (≥6). The OR for patients with a score of 4-5 was 10 and 249 for a score of ≥6. When applied to G2, the positive predictive value was 84.8 % and the negative predictive value was 96.0%.
Conclusions:
CPD are potentially useful for the early diagnosis of sepsis. Their values were used to compose in NEMO score can help in rapid and reliable decision making.
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