Eosinopenia: Is it a good marker of sepsis in comparison to procalcitonin and C-reactive protein levels for patients admitted to a critical care unit in an urban hospital?

Introduction The role of eosinopenia as a marker of sepsis has recently been evaluated The aim of our study was to test the value of eosinopenia as a diagnostic marker of sepsis in comparison to procalcitonin and C reactive protein levels Methods A prospective study of critically ill adult patients admitted to the medical intensive care unit at an urban hospital Procaleitonin C reactive protein (CRP) levels and eosinophil counts were measured on admission Patients were classified as non-infected or infected by the medical residents fellows and attendings Results A total of 68 patients were enrolled into the study At a cut off value of 70 mg/L, the CRP level yielded a sensitivity of 94% a specificity of 84% a positive predicted value (PPV) of 83% and a negative predicted value (NPV) of 94% At a cutoff value of 1 5 mu g/L the sensitivity of the procalcitonin test was 84%, specificity of 92% PPV 90%, and NPV of 87% The eosinophil cell count (cutoff of 50 cells/mm(3)) produced a sensitivity of 81% specificity of 65%, a PPV of 66%, and a NPV of 80% The comparison of the eosinophil cell count (<50 cells/mm(3)) and procalcitonin levels among the noninfected and infected groups showed a significant statistical difference (Fisher exact test, P = 0239) There was no statistical difference observed when comparisons were made between CRP levels and eosinophil count (Fisher exact test P = 12) There was also a lack of significant statistical difference when CRP levels were compared to procalcitonin levels (Fisher exact test, P = 49) Conclusion Eosinopenia is a very sensitive yet not specific serological marker of sepsis in the intensive care unit and can be utilized to guide physicians in the diagnosis of sepsis (C) 2010 Elsevier Inc All rights reserved