Nucleated Red Blood Cells for Predicting Mortality in Intensive Care Unit Patients With Sepsis

BACKGROUND The search for biomarkers to predict the clinical course and mortality of patients with sepsis in the intensive care unit (ICU) remains ongoing. In this study, we aimed to investigate the effectiveness of nucleated red blood cell (NRBC) count and percentage in predicting clinical outcomes and mortality in patients with sepsis monitored in the ICU. MATERIAL AND METHODS This retrospective study included 160 patients with sepsis who were followed in the ICU between March 2023 and March 2024 and stayed for more than 48 hours. Laboratory values and clinical outcomes were compared. RESULTS Eighty-one patients (50.625%) died. The Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation II scores were higher, and the Glasgow Coma Scale scores were lower, in the mortality group (P<0.001 for all). NRBC counts at ICU admission, at discharge, and 48 hours before discharge were significantly higher in patients who died (P=0.029, P=0.004, and P=0.02, respectively). Receiver operating characteristic curve analysis revealed the highest area under the curve (AUC) for NRBC at discharge (AUC=0.631) with a cut-off of 10 NRBC/µL. NRBC at admission had an AUC of 0.6, with a cut-off value of 20 NRBC/µL and specificity of 0.848. CONCLUSIONS NRBC values, when combined with established scoring systems, may aid in guiding sepsis management. Future studies are needed to further evaluate the process and determine cut-off values.