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Original Research
Use of full blood count parameters and haematology cell ratios in screening for sepsis in South Africa
Submitted: 21 October 2022 | Published: 11 April 2023
About the author(s)
Jason van Rensburg, Department of Biomedical Sciences, Faculty of Health and Wellness, Cape Peninsula University of Technology, Cape Town, South AfricaSaarah Davids, South African Medical Research Council/Cape Peninsula University of Technology Cardiometabolic Health Research Unit and Biomedical Sciences, Faculty of Health and Wellness, Cape Peninsula University of Technology, Cape Town, South Africa
Carine Smuts, Department of Biomedical Sciences, Faculty of Health and Wellness, Cape Peninsula University of Technology, Cape Town, South Africa
Glenda M. Davison, South African Medical Research Council/Cape Peninsula University of Technology Cardiometabolic Health Research Unit and Biomedical Sciences, Faculty of Health and Wellness, Cape Peninsula University of Technology, Cape Town, South Africa; and, Division of Haematology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Abstract
Background: Sepsis is characterised by multi-organ failure due to an uncontrolled immune response to infection. Sepsis prevalence is increased in developing countries and requires prompt diagnosis and treatment. Reports, although controversial, suggest that full blood count parameters and cell ratios could assist in the early screening for sepsis.
Objective: The study evaluated the use of haematological cell ratios in screening for sepsis in a South African population.
Methods: The study retrospectively analysed the complete blood counts, blood cultures (BC) and biochemical test results of 125 adult patients who presented between January 2021 and July 2021 at a hospital in Cape Town. An ISO15189-accredited laboratory performed all of the tests. We compared and correlated the automated differential counts, neutrophil, monocyte and platelet-to-lymphocyte ratios with procalcitonin levels. A p-value of < 0.05 was considered significant.
Results: Sixty-two sepsis patients (procalcitonin > 2 ng/L and positive BC) were identified and compared to 63 non-sepsis controls. All cell ratios were significantly elevated in sepsis patients (p < 0.001). However, the two groups had no significant difference in absolute monocyte counts (p = 0.377). In addition, no correlation was detected between any cell ratios and procalcitonin.
Conclusion: In combination with complete blood count parameters, haematology cell ratios can be used for early sepsis detection. The full blood count is widely available, inexpensive, and routinely requested by emergency care clinicians. Although procalcitonin and BC remain the gold standard, the calculation of cell ratios could provide a simple screening tool for the early detection of sepsis.
What this study adds: This study adds evidence to the proposal that calculating haematological cell ratios assists in the early screening of sepsis in a South African setting.
Keywords
Sustainable Development Goal
Metrics
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