title: Sepsis affects most routine and cell population data (CPD) obtained using the Sysmex XN-2000 blood cell analyzer: neutrophil-related CPD NE-SFL and NE-WY provide useful information for detecting sepsis.
abstract: BACKGROUND
  The Sysmex XN-2000 analyzer can assess 36 routine and 57 cell population data (CPD) items. In this study, we evaluated these items as sepsis biomarkers.
  
  
  METHODS
  We enrolled 280 normal control (NC) and 130 sepsis patients. The sepsis patients were classified as uncomplicated or complicated sepsis. Routine and CPD items were determined, and the results were compared at between the NC and sepsis groups, uncomplicated and complicated sepsis groups, and survivors and nonsurvivors.
  
  
  RESULTS
  For the detection of sepsis, CPD items NE-SFL [defined as the fluorescent light intensity of the neutrophil area on the WDF (white blood cell differential) scattergram] and NE-WY (defined as the fluorescent light distribution width of the neutrophil area on the WDF scattergram) showed comparative or higher AUC of 0.909 and 0.905, respectively, when compared with routine items such as hematocrit, hemoglobin, RBC, RDW, immature granulocytes count, lymphocytes count, and neutrophils count. For the discrimination of sepsis severity, only platelet-related items showed higher AUC (0.723 - 0.748) than lactic acid (0.695). For the prediction of 28-day mortality, only CV and SD of RDW showed higher AUC (0.766 and 0.732 each) than lactic acid (0.712).
  
  
  CONCLUSIONS
  Sepsis patients demonstrated significant changes in routine and CPD items related to RBC, neutrophils, lymphocytes, and platelets when compared to NCs. Increase in CPD items NE-SFL and NE-WY, which may indicate neutrophil immaturity or activation, could be useful for the detection of sepsis patients, in conjunction with currently used surrogate sepsis biomarkers. However, these items did not efficiently contribute to the discrimination of sepsis severity or predict mortality.
authors.affiliation: Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Park
authors.forename: C-J
authors.initials: CJ
authors.lastname: Park
authors.forename: B-R
authors.initials: BR
authors.lastname: Lee
authors.forename: K-S
authors.initials: KS
authors.lastname: Nam
authors.forename: M-J
authors.initials: MJ
authors.lastname: Kim
authors.forename: M-Y
authors.initials: MY
authors.lastname: Han
authors.forename: Y J
authors.initials: YJ
authors.lastname: Kim
authors.forename: Y-U
authors.initials: YU
authors.lastname: Cho
authors.forename: S
authors.initials: S
authors.lastname: Jang
mesh_terms: D015415:Biomarkers; D001772:Blood Cell Count / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D016022:Case-Control Studies; D006801:Humans; D009504:Neutrophils / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D015415:Biomarkers
keywords: NE-SFL; NE-WY; Sepsis; Sysmex XN-2000; cell population data; neutrophil