Evaluation of usefulness of myeloperoxidase index (MPXI) for differential diagnosis of systemic inflammatory response syndrome (SIRS) in the emergency department.
BACKGROUND
The myeloperoxidase index (MPXI) is elevated in infection. We ascertained whether MPXI might be useful in differentiation of sepsis versus non-infectious systemic inflammatory response syndrome (SIRS) in emergency department (ED).


METHODS
After exclusion of patients with an age of <18 years, trauma, haematological disease and on anticancer chemotherapy, 444 consecutive cases with SIRS (sepsis: 224, 50.3%; and non-infectious SIRS: 220, 49.7%) diagnosed and treated at the ED of The Wonju Severance Christian Hospital from May 2012 to June 2012 were retrospectively reviewed.


RESULTS
Median MPXI was higher in sepsis versus non-infectious SIRS (0.1 (IQR: -3.1 to 2.5) vs -1.2 (-4.1 to 1.6), respectively, p=0.020). Median white cell count, neutrophil percentage, C reactive protein level and δ neutrophil index were also higher. However, MPXI resulted as not statistically useful for differential diagnostic parameter in analysis.


CONCLUSIONS
MPXI is higher in sepsis than in non-infectious SIRS. However, there is currently no evidence that the MPXI adds any additional benefit to differentiate sepsis from non-infectious SIRS in the ED. Therefore, further study will be needed.
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Republic of Korea.
Yong Sung
YS
Cha
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Republic of Korea.
Jeong Min
JM
Yoon
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Republic of Korea.
Woo Jin
WJ
Jung
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Republic of Korea.
Yong Won
YW
Kim
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Republic of Korea.
Tae Hoon
TH
Kim
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Republic of Korea.
Oh Hyun
OH
Kim
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Republic of Korea.
Kyoung Chul
KC
Cha
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Republic of Korea.
Hyun
H
Kim
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Republic of Korea.
Sung Oh
SO
Hwang
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Republic of Korea.
Kang Hyun
KH
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000097:blood*; D012189:Retrospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis* / Q000201:enzymology
D015415:Biomarkers; D009195:Peroxidase
Diagnosis; Haematology; Infection