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Association between initial bandemia degree and short-term mortality among adults with bacteremia in the emergency
Han Cheng1, Chih-Chia Hsieh2, Ching-Chi Lee3
1Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Objectives:
To evaluate the prognostic role of initial band percentages in adults presenting to the emergency department (ED) with bacteremia.
Methods:
This 8-year retrospective cohort study included treatment-naïve adults with bacteremia who underwent a manual differential hemogram. The primary outcome was 30-day mortality after ED arrival. The association between initial band percentages and mortality was analyzed using a logistic regression model adjusted for independent prognostic factors.
Results:
Of the total 5558 patients, patients were stratified into five groups by the initial percentage of band cells (neutrophils): 0%-10% (3358 patients), 10%-19% (849), 20%-29% (618), 30%-39% (347), and ≥ 40% (386). The groups varied significantly in terms of clinicodemographic characteristics, bacteremia profiles, and mortality rates at 3, 15, and 30 days. Overall, each 10% increase in the initial band percentage was independently associated with an average 12% increase in 30-day mortality rates. The positive association between initial band percentages and 30-day mortality rates remained consistent across predefined patient subgroups.
Conclusions:
A higher initial percentage of band cells is independently associated with a higher risk of short-term mortality in adults presenting to the ED with bacteremia.
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