Differences in Mortality on the Basis of Complete Blood Count in an Unselected Population at the Emergency Department

2006 ◽  
Vol 12 (3) ◽  
pp. 134-138 ◽  
Author(s):  
Karen Vroonhof ◽  
Wouter Van Solinge ◽  
Maroeska Rovers ◽  
Albert Huisman
Keyword(s):  
Emergency Department ◽  
Blood Count ◽  
Complete Blood Count ◽  
Unselected Population

scholarly journals Effectiveness of neutrophil/lymphocyte, lymphocyte/MPV and platelet/MPV ratios in the classification and mortality prediction of acute stroke

2021 ◽  
Vol 8 (2) ◽  
pp. 122-127
Author(s):  
Suna Eraybar ◽  
Melih Yuksel
Keyword(s):  
Emergency Department ◽  
Ischemic Stroke ◽  
Acute Stroke ◽  
Blood Count ◽  
Complete Blood Count ◽  
Mortality Prediction ◽  
Radiological Findings ◽  
Platelet Volume ◽  
Ischemic Cerebrovascular Disease ◽  
Ischemic Group

Objective: The aim of this study is to investigate whether Neutrophil / lymphocyte (NLR), Lymphocyte / MPV (mean platelet volume)  (LMR) and thrombocyte / MPV (PMR) ratios obtained from the complete blood count, can be used as an effective marker in acute stroke for determining the prognosis and subtype of stroke. Material and methods: Patients admitted to the emergency department with acute stroke symptoms between January 1, 2020 and December 31, 2020 were evaluated retrospectively. The patients were divided into two groups as hemorrhagic or ischemic cerebrovascular disease (CVD) according to the radiological findings. NLR, LMR and PMR ratios were calculated. The last diagnosis and hospitalization information were recorded and their 28-day mortality status was evaluated. Results: A total of 764 patients were included in the study. The median age of the patients included in the study was 68 (IQR 25-75: 59-78) and 404 (52.9%) of the patients were male. In the analysis performed; it was observed that the LMR, NLR and PMR levels were significantly different in those who developed mortality on the 28th day (p = 0.009), (p = 0.002), (p = 0.026). In addition, only the NLR level was found to be significantly different in the ischemic group (p <0.001). Conclusion: We think that in cases with stroke, NLR, LMR and PMR levels can be used in predicting the prognosis of this disease. Also, NLR is significantly higher in ischemic stroke, and also significant in terms of showing that CVD type is hemorrhagic or ischemic.

scholarly journals Monocyte distribution width (MDW) performance as an early sepsis indicator in the emergency department: comparison with CRP and procalcitonin in a multicenter international European prospective study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Pierre Hausfater ◽  
Neus Robert Boter ◽  
Cristian Morales Indiano ◽  
Marta Cancella de Abreu ◽  
Adria Mendoza Marin ◽  
...  
Keyword(s):  
Emergency Department ◽  
Blood Count ◽  
Complete Blood Count ◽  
C Reactive Protein ◽  
Systematic Screening ◽  
Distribution Width ◽  
Sepsis Diagnosis ◽  
Reactive Protein ◽  
Early Sepsis ◽  
Sepsis Detection

Abstract Background Early sepsis diagnosis has emerged as one of the main challenges in the emergency room. Measurement of sepsis biomarkers is largely used in current practice to improve the diagnosis accuracy. Monocyte distribution width (MDW) is a recent new sepsis biomarker, available as part of the complete blood count with differential. The objective was to evaluate the performance of MDW for the detection of sepsis in the emergency department (ED) and to compare to procalcitonin (PCT) and C-reactive protein (CRP). Methods Subjects whose initial evaluation included a complete blood count were enrolled consecutively in 2 EDs in France and Spain and categorized per Sepsis-2 and Sepsis-3 criteria. The performance of MDW for sepsis detection was compared to that of procalcitonin (PCT) and C-reactive protein (CRP). Results A total of 1,517 patients were analyzed: 837 men and 680 women, mean age 61 ± 19 years, 260 (17.1%) categorized as Sepsis-2 and 144 patients (9.5%) as Sepsis-3. The AUCs [95% confidence interval] for the diagnosis of Sepsis-2 were 0.81 [0.78–0.84] and 0.86 [0.84–0.88] for MDW and MDW combined with WBC, respectively. For Sepsis-3, MDW performance was 0.82 [0.79–0.85]. The performance of MDW combined with WBC for Sepsis-2 in a subgroup of patients with low sepsis pretest probability was 0.90 [0.84–0.95]. The AUC for sepsis detection using MDW combined with WBC was similar to CRP alone (0.85 [0.83–0.87]) and exceeded that of PCT. Combining the biomarkers did not improve the AUC. Compared to normal MDW, abnormal MDW increased the odds of Sepsis-2 by factor of 5.5 [4.2–7.1, 95% CI] and Sepsis-3 by 7.6 [5.1–11.3, 95% CI]. Conclusions MDW in combination with WBC has the diagnostic accuracy to detect sepsis, particularly when assessed in patients with lower pretest sepsis probability. We suggest the use of MDW as a systematic screening test, used together with qSOFA score to improve the accuracy of sepsis diagnosis in the emergency department. Trial Registration ClinicalTrials.gov (NCT03588325).

Practice Variation In Management Of Children With Sickle Cell Disease Who Present With Fever To The Emergency Department

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1741-1741
Author(s):  
Katherine Eisenbrown ◽  
Oluwakemi Badaki ◽  
Angela M. Ellison ◽  
Mark Nimmer ◽  
David C. Brousseau
Keyword(s):  
Emergency Department ◽  
Sickle Cell Disease ◽  
Blood Culture ◽  
Sickle Cell ◽  
Blood Count ◽  
Complete Blood Count ◽  
Practice Variation ◽  
Diagnostic Evaluation ◽  
Cell Disease ◽  
Children's Hospital

Abstract Background The National Heart, Lung, and Blood Institute Consensus Expert Panel recommends emergency department evaluation for all patients with sickle cell disease who develop a fever. However, it is unclear what recommended components are present in institutional care plans for their patients with sickle cell disease and what variation exists in the evaluation of patients who present with sickle cell disease and fever across institutions. There are few studies evaluating this practice variation and little evidence concerning the appropriate work-up of these children. Our objective was to describe areas where significant practice variation exists in the care of children with sickle cell disease presenting with fever to established sickle cell centers. Methods We undertook a retrospective cross-sectional study of the actual care received at three comprehensive sickle cell centers at pediatric hospitals to understand the diagnostic evaluation, treatment and disposition of children ages 3 months to 21 years presenting to the emergency department with sickle cell disease and fever. Chart reviews were performed on all visits of children presenting with a diagnosis of sickle cell disease to the emergency department of one of the three participating sites between January 1, 2008 and December 31, 2012. All charts were reviewed, and any chart with a documented fever ≥ 38.5°C, either at home or in the emergency department, was included for analysis. Data abstraction included laboratory and radiographic evaluation as well as antibiotic use and disposition. All children pretreated with an antibiotic within the past 24 hours were excluded from the analysis as this could alter the diagnostic evaluation and disposition of these patients. Descriptive statistics were used to determine the percent of children who received a chest radiograph, blood culture, complete blood count, urinalysis, electrolytes, treatment with an antibiotic, and disposition of hospital admission. Due to the large sample sizes, relatively small differences in proportions were determined to be statistically significant; however, differences of less than 10 percent were not considered to necessarily be indicative of clinically meaningful differences in evaluation or treatment, and therefore differences smaller than 10% were reported as similar. Results Analysis to date reveals complete evaluation of 1251 visits [673 at the Children's Hospital of Wisconsin (CHW), 368 at Children's National Medical Center (CNMC), and 210 at Children's Hospital of Philadelphia (CHOP)]. The median age of the children at these visits was 3.4 years (interquartile range of 1.4 - 7.7). Analysis of diagnostic testing revealed approximately 98 percent of patients received a complete blood count and a blood culture, with no difference between sites. Ninety-three percent of patients were treated with an antibiotic, which also showed no meaningful difference across sites. Analysis of disposition revealed significant differences between sites, with 49%, 47%, and 100% of patients admitted to the inpatient units at CHW, CNMC and CHOP, respectively. Likewise, significant differences were seen in obtaining chest radiographs: 81%, 92%, and 29% at CHW, CNMC and CHOP, respectively. The percent of patients who received a urinalysis ranged from a high of 39% at CNMC to a low of 18% at CHOP. Electrolytes were obtained from 3%, 48% and 1% of patients at CHW, CNMC and CHOP, respectively. Conclusion Consistent with NHLBI guidelines, essentially all children with sickle cell disease presenting to the emergency department with fever receive a complete blood count, blood culture and antibiotics. These equal proportions suggest similar treatment guidelines across sites. There is significant variation between sites in the proportion of children who receive a chest x-ray, urinalysis, electrolytes and perhaps most importantly, admission to the hospital. These examples of practice variation may represent potential areas for quality improvement efforts to better define best care practices for children with sickle cell disease presenting to the emergency department for fever. Disclosures: No relevant conflicts of interest to declare.

Sign in / Sign up

Export Citation Format

Share Document