ANALYSIS OF PROGNOSTIC VALUE OF LEUKOCYTE AND HEMATOLOGICAL INDEXES OF INTOXICATION IN THE DIAGNOSIS OF SURGICAL SEPSIS

Andrii Pavliak

Abstract


The mortality from surgical sepsis remains high and ranges from 17 to 83.7 %. The cause of high lethality is endogenous intoxication and multiple organ failure. The most common laboratory markers for determining the syndrome of endogenous intoxication in surgical sepsis are leukocyte and hematological intoxication indices, such as LII, HII, NII.

Aim of the work: to study the predictive value of laboratory and hematological indicators of intoxication in the diagnosis of surgical sepsis.

Materials and methods. A retrospective analysis of disease history and prospective follow-up of 41 patients treated for surgical sepsis in the Ivano-Frankivsk (Ukraine) Surgical Department of the CCCH in period between August 2015 and August 2018 was conducted. In the first day after the operation, all the patients been calculated the leukocyte index of intoxication, the hematological index of intoxication and the nuclear index of intoxication to assess their predictive and diagnostic significance. Methods of nonparametric statistics were used in the study: ROC-analysis, Mann-Whitney U-test, Spierman's criterion (Rs).

Results. The results of the diagnostic and prognostic significance of LII, HII, NII for 1 day postoperative period, with regard to the prediction of lethality by means of ROC analysis, Mann-Whitney U-test, Spirman criteria (Rs) showed low sensitivity and specificity in patients with surgical sepsis.

Common laboratory leukocyte and hematological non-specific indicators of endogenous intoxication determination have low prognostic and diagnostic significance in assessing the degree of endotoxicosis in surgical sepsis and can not serve as prognostic criteria for lethality.

Conclusions. The problem of diagnosing endotoxicosis in surgical sepsis requires the further study and introduction into clinical practice of new specific and integrated clinical and laboratory methods for the quantitative determination of endotoxicosis, which could serve as a reliable diagnostic criterion in assessing the severity of the condition and the prediction of hospital mortality.


Keywords


endogenous intoxication; leukocyte index of intoxication; hematological index of intoxication; nuclear toxicity index; surgical sepsis

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References


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DOI: http://dx.doi.org/10.21303/2585-663.2018.00772

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ISSN 2585-6634 (Online), ISSN 2585-6626 (Print)