白细胞计数与细菌病之间的关系使用住院患者间隔概率比率
Erin Sullivan1, Rebecca Schulte2, Sidra L Speaker3
1Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA.
Journal of general internal medicine
|October 22, 2024
概括
升高的白细胞 (WBC) 和中性粒细胞数量是细菌病的不良预测指标. 间隔概率比率 (ILR) 提供了比简单的值更准确的细菌病风险评估,特别是高或低值.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 传染病研究 传染病研究
- 血液学 血液学 血液学
背景情况:
- 升高的白细胞 (WBC) 和中性粒细胞数量在细菌病患者中很常见.
- 然而,仅仅这些标记不够预测细菌血症.
- 缺乏关于WBC反应和细菌血症之间的连续关系的数据.
研究的目的:
- 描述白细胞计数,中性粒细胞百分比和绝对中性粒细胞计数 (ANC) 和细菌血症之间的关系.
- 使用间隔概率比 (ILRs) 来更精确地估计细菌病概率.
- 为了比较ILR与传统值方法的区分能力.
主要方法:
- 在2017-2018年期间,对25776名住院患者进行了回顾性队列研究.
- 包括非手术性住院患者,全血细胞计 (CBC) 与差异和血液培养.
- 用ILR和AUROC分析了白细胞计数,ANC和中性粒细胞百分比作为细菌病的预测指标.
主要成果:
- 中性粒细胞的百分比显示出对细菌血症的最高分辨能力 (AUROC 0.74).
- 细菌病的概率呈指数级增加,中性粒细胞的百分比从80%增加到100%.
- 使用70%中性粒细胞的值方法低估了高水平的细菌病风险.
结论:
- 与单个值相比,间隔概率比率 (ILR) 为估计细菌病概率提供了一种更具歧视性的方法.
- 白细胞和中性粒细胞异常的程度对于预测细菌病风险至关重要.
- 医生应该考虑整个价值谱,而不仅仅是二分化结果,以准确评估风险.
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