title: Fraction of immature granulocytes reflects severity but not mortality in sepsis.
abstract: OBJECTIVE
  In order to validate immature granulocytes as a universal biomarker, we have compared the clinical relevance of the proportion of immature granulocytes (IG%), measured using Sysmex XE-2100, with other biomarkers (white blood cell, C-reactive protein, lactate and procalcitonin).
  
  
  METHODS
  This single center, retrospective study included 184 patients with sepsis admitted to an emergency department. Patients were classified into two groups: Uncomplicated sepsis and complicated sepsis (severe sepsis and septic shock). IG% and other biomarkers were evaluated and compared for predicting sepsis severity, overt disseminated intravascular coagulation (DIC) and 28 day mortality.
  
  
  RESULTS
  In multivariate analysis, only IG% (odd ratio [OR] 2.530, p = 0.004) and lactate (OR 4.500, p < 0.001) could discriminate between complicated and uncomplicated sepsis. The optimal cut-off value for IG% and lactate was 0.5% and 2.0 mmol/L, respectively. In subgroup analyses of complicated sepsis, IG% was related to overt DIC. However, no single biomarker could predict 28-day mortality.
  
  
  CONCLUSIONS
  Given that IG% reflected sepsis severity and overt DIC without additional cost, IG% could be a useful biomarker in patients with sepsis. However, there is a limitation for using it as a novel biomarker in sepsis due to the disability of prediction for 28-day mortality.
authors.affiliation: Department of Emergency Medicine, Hallym University Medical Center , Kyoungki-do.
authors.forename: Sang Ook
authors.initials: SO
authors.lastname: Ha
authors.forename: Sang Hyuk
authors.initials: SH
authors.lastname: Park
authors.forename: So Hee
authors.initials: SH
authors.lastname: Park
authors.forename: Jae Seok
authors.initials: JS
authors.lastname: Park
authors.forename: Jin Won
authors.initials: JW
authors.lastname: Huh
authors.forename: Chae-Man
authors.initials: CM
authors.lastname: Lim
authors.forename: Younsuck
authors.initials: Y
authors.lastname: Koh
authors.forename: Sang-Bum
authors.initials: SB
authors.lastname: Hong
authors.forename: Seongsoo
authors.initials: S
authors.lastname: Jang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006098:Granulocytes / Q000276:immunology*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012372:ROC Curve; D018805:Sepsis / Q000276:immunology / Q000401:mortality* / Q000473:pathology; D012720:Severity of Illness Index; D016019:Survival Analysis
keywords: Analyzer; C-reactive protein; DIC; biomarker; lactate; procalcitonin