Background
Outcome prediction in septic shock is a prime concern as it may facilitate more aggressive interventions to be made at appropriate time to reduce costs and mortality. We evaluated combining complete blood count (CBC) indices [red cell distribution width (RDW), mean platelet volume (MPV), neutrophil–lymphocyte ratio (NLR)] for septic shock early prognostication in comparison to presepsin.
Methods
Sixty adult intensive care unit (ICU) patients with septic shock according to Sepsis-3 were enrolled. Blood assembling on admission and day 3 to determine presepsin level, and CBC indices which were interpreted as RDW, MPV, and NLR. Patients were sorted into survivors (Group I) and non-survivors (Group II).
Results
Presepsin in non-survivors was higher significantly on admission and day 3 ( < 0.00 <0.00 respectively). RDW in non-survivors was higher significantly on admission and day 3 ( = 0.0 0.00 respectively). MPV in non-survivors was higher significantly on admission and day 3 ( = 0.030, 0.00 respectively). NLR in non-survivors was higher significantly on admission and day 3 ( = 0.00 <0.00 respectively). The calculated AUCs were 0.890 ( < 0.00 for presepsin, with 9% sensitivity, 83% specificity, and 88% accuracy, and 0.84 ( < 0.00 for CBC indices combination, with 89% sensitivity, 85% specificity, and 86% accuracy. Significant positive correlation was found between presepsin and CBC indices combination ( = 0.4,  = 0.00.
Conclusion
Combination of RDW, MPV, and NLR could be integrated into septic shock early prognostication tools with sensitivity, specificity, and accuracy similar to presepsin.