Comparative study between complete blood picture indices and presepsin as early prognostic markers in septic shock patients

Abstract

Background: Outcome prediction in septic shock is a prime concern as it may facilitate more aggressive interventions to be made at appropriate time to reduce costs and mortality. We evaluated combining complete blood count (CBC) indices [red cell distribution width (RDW), mean platelet volume (MPV), neutrophil–lymphocyte ratio (NLR)] for septic shock early prognostication in comparison to presepsin. Methods: Sixty adult intensive care unit (ICU) patients with septic shock according to Sepsis-3 were enrolled. Blood assembling on admission and day 3 to determine presepsin level, and CBC indices which were interpreted as RDW, MPV, and NLR. Patients were sorted into survivors (Group I) and non-survivors (Group II). Results: Presepsin in non-survivors was higher significantly on admission and day 3 (p < 0.001, <0.001, respectively). RDW in non-survivors was higher significantly on admission and day 3 (p = 0.022, 0.001, respectively). MPV in non-survivors was higher significantly on admission and day 3 (p = 0.030, 0.001, respectively). NLR in non-survivors was higher significantly on admission and day 3 (p = 0.001, <0.001, respectively). The calculated AUCs were 0.890 (p < 0.001) for presepsin, with 92% sensitivity, 83% specificity, and 88% accuracy, and 0.842 (p < 0.001) for CBC indices combination, with 89% sensitivity, 85% specificity, and 86% accuracy. Significant positive correlation was found between presepsin and CBC indices combination (r = 0.417, p = 0.001). Conclusion: Combination of RDW, MPV, and NLR could be integrated into septic shock early prognostication tools with sensitivity, specificity, and accuracy similar to presepsin.