1039. Simple scoring system using red cell distribution, delta neutrophil index, and platelet count for prediction of mortality in patients with severe sepsis or septic shock
Session: Poster Abstract Session: Clinical Infectious Diseases: Bacteremia and Endocarditis
Friday, October 28, 2016
Room: Poster Hall
Background: Red cell distribution (RDW), delta-neutrophil index (DNI), and platelet count are known as significant prognostic factors for predicting mortality of patients with sepsis. The values of those factors can be readily estimated by a complete blood count (CBC). We made a scoring system using RDW, DNI, and platelet count and evaluated the prognostic value of the score in patients with severe sepsis or septic shock.

Methods: A retrospective cohort study was performed at a tertiary hospital in South Korea. Patients who received early goal-directed therapy (EGDT) due to severe sepsis or septic shock from January 2015 to December 2015 were included. We rated the score on a scale of 0 to 3. A point value was assigned to the scoring system using definition of the following; RDW 14.6 %, DNI 5.1 %, platelet count < 150,000/mm3.

Results: A total of 115 patients were included for this study. 58 patients (Group A) received less than 2 point value (0 or 1) and 57 patients (Group B) received more than 2 point value (2 or 3). Group B had a higher 28-day mortality rate (1.7% vs. 21.1%, P = 0.001) and higher Sequential Organ Failure Assessment (SOFA) score (6.28 vs. 9.26, P < 0.001), compared to Group A. There were significant differences in creatinine (1.67 vs. 2.6, P = 0.011), total bilirubin (0.81 vs. 1.49, P = 0.006), albumin (3.26 vs. 2.91, P =0.003), and C-reactive protein (CRP) (100.26 vs. 154.56, P = 0.002) between two groups. In multivariate Cox proportional hazard analysis, high score (defined as ≥ 2 point value) was independently associated with 28-day mortality (adjusted HR 9.17, 95% confidential interval 1.16 - 72.3, P = 0.035).

Conclusion: Our scoring system using RDW, DNI, and platelet count, which are easily assessed from CBC, can be considered as an useful scoring system for prediction of mortality in patients with severe sepsis or septic shock.

Yong Chan Kim, MD1, Moo Hyun Kim, MD2, Woo Yong Jeong, MD2, Dong Hyun Oh, MD3, Eun Jin Kim, MD4, Je Eun Song, MD5, In Young Jung, MD4, Su Jin Jeong, MD/PhD6, Jun Yong Choi, MD, PhD3, Young Goo Song, MD, PhD7, June Myung Kim, MD, PhD3 and Nam Su Ku, MD3, (1)Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea, Seoul, Korea, The Republic of, (2)AIDS Research Institue, Yonsei University of Medicine, Seoul, Korea, The Republic of, (3)Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea, (4)AIDS Research Institute, Yonsei University college of Medicine, Seoul, Korea, The Republic of, (5)Department of Infection Control, Yonsei University College of Medicine, Seoul, Korea, The Republic of, (6)Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea, (7)AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea

Disclosures:

Y. C. Kim, None

M. H. Kim, None

W. Y. Jeong, None

D. H. Oh, None

E. J. Kim, None

J. E. Song, None

I. Y. Jung, None

S. J. Jeong, None

J. Y. Choi, None

Y. G. Song, None

J. M. Kim, None

N. S. Ku, None

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