Delta Immature Platelet Fraction Is Associated With Mortality in Bacteremia Patients

Author:

Shih Pei‐Chun1,Wang Yi‐Hua1,Chen Shey‐Ying2,Tseng Min1,Hsu Cheng‐An1,Yang Ming‐Yan3,Wang Hsin‐Yao45,Lee Jia‐Arng16ORCID

Affiliation:

1. Department of Laboratory Medicine, National Taiwan University Hospital National Taiwan University College of Medicine Taipei Taiwan

2. Center for Quality Management, National Taiwan University Hospital National Taiwan University College of Medicine Taipei Taiwan

3. Department of Medical Education, National Taiwan University Hospital National Taiwan University College of Medicine Taipei Taiwan

4. Department of Laboratory Medicine Chang Gung Memorial Hospital at Linkou Taoyuan City Taiwan

5. School of Medicine National Tsing Hua University Hsinchu Taiwan

6. Graduate Institute of Clinical Laboratory Sciences and Medical Biotechnology National Taiwan University Taipei Taiwan

Abstract

ABSTRACTObjectivesImmature platelet fraction (IPF) for differentiating bacteremia has been explored, whereas its prognostic correlation remains uncertain. This study aims to confirm the predictive capability of IPF for bacteremia and investigate its association with prognosis.MethodsPatients with complete blood count (CBC) on the blood culture day (D1) and the preceding day (D0) were retrospectively recruited and categorized into bacteremia and nonbacteremia groups. Immature platelet (IP) analysis, alongside CBC, was conducted. Delta IPF, defined by the absolute values of D1 minus D0 results was calculated. The ability to distinguish bacteremia from nonbacteremia patients, and the correlation with mortality were analyzed.ResultsFrom February to December 2020, a total of 150 patients were enrolled, with 75 having bacteremia. The specificity for delta IPF ≥3.4% to predict bacteremia was 97.3% (95% confidence interval [CI]: 90.7–99.7). When delta IPF ≥3.4% combined with procalcitonin ≥0.5 (ng/mL), the sensitivity was 90.5% (95% CI: 69.6%–98.8%). Within the bacteremia group, delta IPF and the proportion of patients with delta IPF ≥1.5% were significantly higher in nonsurvival, while delta platelet levels did not. Furthermore, delta IPF ≥1.5% was independently associated with 30‐day mortality (adjusted odds ratio: 3.88, 95% CI: 1.2%–11.4%; p = 0.020). The 30‐day survival curve demonstrated a significant difference between patients with delta IPF ≥1.5% and those without (p < 0.001).ConclusionsDelta IPF correlates with mortality in bacteremia patients. Our findings suggest IPF not only helps detect bacteremia but also predicts prognosis in the early stage.

Funder

National Taiwan University Hospital

Publisher

Wiley

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