Diabetic ketoacidosis and infection: leukocyte count and differential as early predictors of serious infection |
| |
| Authors: | C M Slovis V G Mork R J Slovis R P Bain |
| |
| Institution: | 1. Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.;2. Department of Biometry, Emory University School of Medicine, Atlanta, Georgia, USA.;3. Emergency Medicine Residency Program, Emory University School of Medicine, Atlanta, Georgia, USA.;4. Grady Memorial Hospital, Atlanta, Georgia, USA.;1. Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy;2. Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy;3. Division of Digestive Endoscopy, University Hospital of Messina, Italy;4. Department of Human Pathology of the Adult and Evolutive Age, University of Messina, Messina, Italy;1. Division of Endocrinology and Diabetes, Medanta the Medicity Hospital, Gurugram, 122001, Haryana, India;2. Institute of Critical Care and Anesthesia, Medanta the Medicity Hospital, Gurugram, 122001, Haryana, India;1. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Saint Louis University School of Medicine, Saint Louis, Missouri;2. Division of Endocrinology, Diabetes and Metabolism, Saint Louis University School of Medicine, Saint Louis, Missouri;1. Renal Division, St Michael’s Hospital and University of Toronto, Ontario, Canada;2. Keenan Research Center in the Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada;3. Division of Pediatric Critical Care Medicine, Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil;1. Residente de Endocrinología. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubiran”, Universidad Nacional Autónoma de México, Ciudad de México, Mexico;2. Unidad de Investigaciones Metabólicas, San Luis Potosí, Mexico;3. Departamento de Endocrinología, Hospital Central “Ignacio Morones Prieto”, San Luis Potosí, Mexico;4. Departamento de Epidemiología Clínica, Facultad de Medicina Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico |
| |
| Abstract: | The records of 153 patients who presented to an emergency department with diabetic ketoacidosis were reviewed to determine whether any admission evaluation laboratory data could serve as a predictor of occult or coexisting infection. Ten patients with admission radiographs already demonstrating active infection (pneumonia or tuberculosis) and two patients with wet gangrene of an extremity were not included in subsequent statistical analysis, as their infections were diagnosed on initial evaluation. Analysis of readily available admission variables revealed that when age, sex, temperature, glucose, serum bicarbonate, pH, total leukocyte count, and differential are subjected to univariate and multivariate discriminant analysis, only an elevation in band neutrophils reliably predicted infection. Approximately half of our patients with elevated band counts (10 or greater) had a coexisting occult infection. An elevated band count was predictive of an occult coexisting major infection with a sensitivity of 100% (19/19) and a specificity of 80% (98/122). |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
