[Evaluation of eosinopenia as an infection marker in critical care patients].
BACKGROUND
To evaluate eosinopenia as an early marker of infection.


METHODS
Retrospective cohort study.


METHODS
Medical-surgical ICU patients with high severity scores.


METHODS
Data on days 1-5: Demographic data, diagnosis, clinical repercussion, mechanical ventilation, clinical development, length of stay, APACHE II, leukocytes, SOFA and lactate. Patients divided into two groups: with and without infection. ROCs (receiver operator characteristic) curves were plotted and best point for discriminative values determined.


RESULTS
244 patients were included: 22.5% with infection. 52.9% medical, 22.5% surgical and 24.6% polytrauma patients. APACHE II: 14.9+/-8.9. In a logistic regression model of infection (dependent variable infection), the independent variables were: APACHE II, SOFA, monocytes and eosinophils. The ROC curve for eosinophils on the first day: area of 0.72; the best cut off value is 10 eosinophils/microl, with sensitivity (S): 64.8% and specificity (Sp): 70.9%. In medical patients, the area under curve is 0.80, with ideal cut off value of 9 eosinophils/microl; in surgical patients is 0.53, with a cut off ideal value of 54. We combined eosinophils and monocytes: a cut-off value of 9 eosinophils/microl in medical patients with >400 monocytes/microl, has: S: 86.7%, Sp: 74.7%, a positive predictive value (PPV) of 40.6% and a negative predictive value (NPV) 96.6%; in postsurgical patients with <400 monocytes/microl and a cut-off value of 54 eosinophils: S: 100%, Sp: 20%, PPV: 52.9% and NPV: 100%.


CONCLUSIONS
In a medical-surgical ICU, the capacity to discriminate infection through examining eosinopenia is not high. It could be useful to rule out infection if we combined eosinopenia with monocytes count.
López de Toro Martín Consuegra
I
I
Unidad de Cuidados Intensivos, Hospital Virgen de la Salud, Toledo, España.
Sánchez Casado
M
M
Rodríguez Villar
S
S
Raigal Caño
A
A
López Reina Torrijos
P
P
Velasco Ramos
A
A
Sánchez Rodríguez
P
P
Cabezas Martín
H
H
D015331:Cohort Studies; D003422:Critical Care; D042241:Early Diagnosis; D004804:Eosinophils; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications* / Q000175:diagnosis*; D007970:Leukopenia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies