title: Immature platelet fraction in predicting sepsis in critically ill patients.
abstract: OBJECTIVE
  To establish whether in critically ill patients without sepsis at intensive care unit (ICU) admission the percentage immature platelet fraction (IPF%) is a cellular marker predicting sepsis to verify a possible correlation between IPF% changes and manifest sepsis and describe the IPF% time course after ICU admission.
  
  
  METHODS
  Prospective, observational 7-day study of 64 adult patients admitted to a general ICU at a University Hospital with no sepsis criteria. We measured daily IPF%, procalcitonin (PCT), C-reactive protein, platelets, white blood cell count and coagulation variables. Thirty-one patients with sepsis at ICU admission were studied as controls.
  
  
  RESULTS
  The only variable we tested at ICU admission that predicted sepsis was plasma IPF% (p < 0.001; >4.7 %: sensitivity 56.2 % IC 37.7-73.6; specificity 90.0 % IC 73.4-97.8). IPF% and PCT values were higher for the patients who had sepsis at admission and during the study than in patients in whom sepsis never developed (IPF%: p = 0.017; PCT: p = 0.030). Among the outcome variables, logistic regression was identified as the only variable related to the development of sepsis, IPF% (r = 0.51; p = 0.004). In patients who developed sepsis IPF% was inversely correlated with platelet count (r = -0.60; p < 0.001) and had high values before sepsis became manifest, decreasing significantly on the 2nd day thereafter.
  
  
  CONCLUSIONS
  In patients without sepsis at ICU admission IPF% increases before sepsis becomes manifest. Measuring IPF% through an easily available technology can therefore provide an early cellular marker predicting the development of sepsis.
authors.affiliation: Anaesthesiology and Intensive Care, Faculty of Medicine and Psycology, University La Sapienza, via di Grottarossa 1035, 00189, Rome, Italy. radbl@libero.it
authors.forename: Roberto Alberto
authors.initials: RA
authors.lastname: De Blasi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Cardelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Costante
authors.forename: Micol
authors.initials: M
authors.lastname: Sandri
authors.forename: Marco
authors.initials: M
authors.lastname: Mercieri
authors.forename: Roberto
authors.initials: R
authors.lastname: Arcioni
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D016638:Critical Illness; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007958:Leukocyte Count; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D018805:Sepsis / Q000097:blood / Q000175:diagnosis*; D013921:Thrombocytopenia / Q000175:diagnosis / Q000209:etiology*
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide