Abstract

Introduction: Sepsis exists on a continuum of severity, ranging from infection and bacteremia to sepsis and septic shock, which can lead to multiple organ dysfunction syndrome (MODS) and death. The clinical and biologic phenotype of sepsis is modified by pre existing illness, co morbid conditions, medications and interventions. Overall mortality among patients admitted with sepsis in the ICU will be around 62%. Since cultures are positive only in < 50% of the cases, various biochemical markers are evaluated to improve the diagnostic sensitivity and prognosis. This study compared the usefulness of Absolute Eosinophil Count (AEC) and C Reactive Protein (CRP)

Materials and Methods: A prospective case control study was done using 61 cases and controls. The cut off for AEC was 35 and the cut off of CRP was 6. The cases were followed up till their end point in the hospital, defined as cured or died. The sensitivity, specificity and predictive values of AEC and CRP in diagnosing sepsis at the defined cut off was calculated using ROC curve. The prognostic accuracy was also calculated.

Observations: The mortality rate of sepsis in our institution is 83.6%. The sensitivity, specificity, Positive and Negative Predictive Values of Absolute Eosinophil count in diagnosis of sepsis is 57.4%, 98.4%, 97.2% and 69.8% respectively. The sensitivity, specificity, Positive Predictive Value and Negative Predictive Value of C Reactive protein is 91.8%, 91.8%, 91.8% and 99.8% respectively.. Of the 51 deaths, 46 had CRP more than 6. Among the 10 cases cured, all had a CRP more than 6.  Absolute Eosinophil Count of < 50 was seen in 29 of the 5eaths, and 6 of the 10 cases who were cured also had an AEC of < 50. So according to our study, both CRP and AEC are poor predictors of prognosis in sepsis.