• Sang Ook Ha, Sang Hyuk Park, So Hee Park, Jae Seok Park, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Sang-Bum Hong, and Seongsoo Jang.
• Department of Emergency Medicine, Hallym University Medical Center , Kyoungki-do.
• Scand. J. Clin. Lab. Invest. 2015 Jan 1; 75 (1): 36-43.

ObjectiveIn order to validate immature granulocytes as a universal biomarker, we have compared the clinical relevance of the proportion of immature granulocytes (IG%), measured using Sysmex XE-2100, with other biomarkers (white blood cell, C-reactive protein, lactate and procalcitonin).MethodsThis single center, retrospective study included 184 patients with sepsis admitted to an emergency department. Patients were classified into two groups: Uncomplicated sepsis and complicated sepsis (severe sepsis and septic shock). IG% and other biomarkers were evaluated and compared for predicting sepsis severity, overt disseminated intravascular coagulation (DIC) and 28 day mortality.ResultsIn multivariate analysis, only IG% (odd ratio [OR] 2.530, p = 0.004) and lactate (OR 4.500, p < 0.001) could discriminate between complicated and uncomplicated sepsis. The optimal cut-off value for IG% and lactate was 0.5% and 2.0 mmol/L, respectively. In subgroup analyses of complicated sepsis, IG% was related to overt DIC. However, no single biomarker could predict 28-day mortality.ConclusionsGiven that IG% reflected sepsis severity and overt DIC without additional cost, IG% could be a useful biomarker in patients with sepsis. However, there is a limitation for using it as a novel biomarker in sepsis due to the disability of prediction for 28-day mortality.

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