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Comparison of Band Percentage vs Immature Granulocyte Percentage in the Setting of Possible Infection Principle
Daniel Hershberger1, Kaeli Samson2, M Ahsan Saeed3
1Department of Internal Medicine, Division of Pulmonary and Critical Care, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Insights
Immature granulocyte percentage, an automated measure, does not correlate with band count, a manually interpreted marker, for early sepsis detection. This finding suggests immature granulocytes may not be a reliable substitute for band counts in identifying potential infections.
Area of Science:
- Clinical pathology
- Hematology
- Infectious disease diagnostics
Background:
- Sepsis is a leading global cause of death, necessitating early and accurate identification.
- Current System of Early Recognition (SIRS) criteria include band count, a manual method prone to variability.
- Automated immature granulocyte counts offer potential for improved accuracy and cost-effectiveness.
Purpose of the Study:
- To compare the diagnostic utility of immature granulocyte percentage versus band percentage in identifying sepsis.
- To determine if immature granulocyte percentage can serve as a sensitive automated alternative to band counts.
Main Methods:
- Retrospective chart review at an academic medical center.
- Analysis of data from patients meeting SIRS criteria, including immature granulocyte and band percentages.
- Statistical analysis using Spearman correlations, Wilcoxon rank-sum tests, and logistic regressions.
Main Results:
- No significant association was found between immature granulocyte percentage and band percentage.
- Immature granulocyte percentage did not correlate with other SIRS criteria.
- The study did not support using immature granulocyte percentage as a direct substitute for band count.
Conclusions:
- Immature granulocyte percentage is not a reliable correlate of band percentage in patients with suspected infections.
- Automated immature granulocyte counts may not effectively replace manual band counts for sepsis screening.
- Further research is needed to validate automated markers for sepsis diagnosis.
Abstract:
Background: Sepsis is a major cause of mortality worldwide. Early identification and treatment are critical to improve survival. Band count has been used as part of SIRS criteria for the early identification of potentially septic patients. Unfortunately, band count requires manual interpretation. This leads to increased potential for intraobserver variability. Immature granulocytes are counted in an automated fashion, which has the potential to improve accuracy and reduce costs. Research Objective: We aim to compare the band percentage and immature granulocyte percentage to set the threshold for immature granulocyte percentage equal to the sensitivity of > 10% band count. Methods: A retrospective chart review was conducted at a single academic medical center. Data from patients with SIRS criteria and measured immature granulocyte and band percentages were utilized to explore potential associations between immature granulocyte percentages and band percentages. Data were analyzed using Spearman correlations, Wilcoxon rank-sum tests, and logistic regressions. Results: We found no significant associations between immature granulocyte percentage and band percentage or other SIRS criteria. Conclusion: We conclude that immature granulocyte percentage does not correlate with band percentage in the setting of possible infection.
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