Porizka Michal, Volny Lukas, Kopecky Petr, Kunstyr Jan, Waldauf Petr, Balik Martin
Department of Anaesthesiology, Resuscitation and Intensive Medicine, General University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic.
Department of Anesthesiology and Intensive Care, Third Faculty of Medicine, University Hospital Kralovske Vinohrady, Charles University, Prague, Czech Republic.
Interact Cardiovasc Thorac Surg. 2019 Jun 1;28(6):845-851. doi: 10.1093/icvts/ivy360.
Usefulness of immature granulocyte percentage (IG%) to discriminate between postoperative non-infective systemic inflammatory response syndrome (SIRS) and sepsis was tested in cardiac surgical patients.
A retrospective analysis of 124 patients who developed non-infective SIRS and sepsis after elective cardiac surgery was performed. Predictive ability of IG% to predict sepsis was compared to procalcitonin (PCT), white blood cell count, temperature and different biomarker combinations using receiver operating characteristic and logistic regression analysis. The optimal cut-off points, diagnosis sensitivity and specificity were calculated.
There were 44 patients diagnosed with sepsis and 80 patients with non-infective SIRS. In receiver operating characteristic analysis, area under the curve was higher for IG% (0.71) and PCT (0.72) compared to white blood cell count (0.62) and temperature (0.58). The best cut-off value for IG% was 1.45% (sensitivity 70.5%, specificity 60%) and 1.43 µg/l for PCT (sensitivity 65.9%, specificity 75%). The combination of IG% and PCT provided the best sepsis prediction (area under the curve of 0.8, sensitivity 63.6% and specificity 88.8%).
In cardiac surgical patients, IG% is a helpful marker with the moderate ability to discriminate between sepsis and non-infective SIRS, comparable to serum PCT. A combination of these parameters increased the test's overall predictive ability by improving its specificity.
在心脏手术患者中测试未成熟粒细胞百分比（IG%）用于区分术后非感染性全身炎症反应综合征（SIRS）和脓毒症的效用。
对124例择期心脏手术后发生非感染性SIRS和脓毒症的患者进行回顾性分析。使用受试者工作特征曲线和逻辑回归分析，将IG%预测脓毒症的能力与降钙素原（PCT）、白细胞计数、体温及不同生物标志物组合进行比较。计算最佳截断点、诊断敏感性和特异性。
44例患者被诊断为脓毒症，80例患者为非感染性SIRS。在受试者工作特征曲线分析中，与白细胞计数（0.62）和体温（0.58）相比，IG%（0.71）和PCT（0.72）的曲线下面积更高。IG%的最佳截断值为1.45%（敏感性70.5%，特异性60%），PCT的最佳截断值为1.43μg/l（敏感性65.9%，特异性75%）。IG%和PCT的组合对脓毒症的预测效果最佳（曲线下面积为0.8，敏感性63.6%，特异性88.8%）。
在心脏手术患者中，IG%是一个有用的标志物，区分脓毒症和非感染性SIRS的能力中等，与血清PCT相当。这些参数的组合通过提高特异性增强了检测的整体预测能力。
