Ann Lab Med.  2016 Jan;36(1):1-8. 10.3343/alm.2016.36.1.1.

Immature Platelet Fraction in Septic Patients: Clinical Relevance of Immature Platelet Fraction is Limited to the Sensitive and Accurate Discrimination of Septic Patients From Non-Septic Patients, Not to the Discrimination of Sepsis Severity

• Park SH
• Ha SO
• Cho YU
• Park CJ
• Jang S
• Hong SB

• KMID: 2373490
• DOI: http://doi.org/10.3343/alm.2016.36.1.1

Abstract

BACKGROUND
The immature platelet fraction (IPF) reflects the degree of reticulated platelets. We evaluated performances of IPF as a biomarker for the discrimination of septic patients from non-septic patients and sepsis severity.
METHODS
Total 312 patients admitted between March and July 2013 were enrolled and samples were obtained at admission. Lactate (LA), procalcitonin (PCT), C-reactive protein (CRP), immature granulocyte fraction (IG), immature reticulocyte fraction (IRF), and IPF were analyzed as sepsis biomarkers and their performances were compared.
RESULTS
The performance of IPF (area under the curve [AUC]=0.868) in the discrimination of septic patients from non-septic patients was comparable to PCT/CRP/LA/IG (AUC=0.923/0.940/0.781/0.812, P=0.233/0.106/0.186/0.353, respectively), and was significantly better than the IRF (AUC=0.658, P=0.007). Sensitivity (89.8%, 95% confidence interval [CI] 84.9-99.8%) and accuracy (83.2%, 95% CI 78.8-90.0%) of IPF were the best among all biomarkers. The performance of IPF in discriminating septic patients from non-septic patients with local infection showed similar results. However, the IPF could not efficiently discriminate sepsis severity (AUC=0.599), similar to other biomarkers (AUC=0.519-0.752).
CONCLUSIONS
The IPF possessed high sensitivity/accuracy in discriminating septic patients from non-septic patients, regardless of local infection status. However, the IPF did not efficiently discriminate sepsis severity. The clinical relevance of IPF as a sepsis biomarker is, therefore, limited to sensitive and accurate discrimination of septic patients from non-septic patients, not discrimination of sepsis severity.

Keyword

Biomarker; Discrimination; Immature platelet fraction; Sepsis; Severity

MeSH Terms

Adult
Aged
Aged, 80 and over
Biomarkers/blood
Blood Platelets/*pathology
Female
Humans
Male
Middle Aged
Reticulocytes/pathology
Sepsis/*blood/diagnosis
Young Adult
Biomarkers

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