Diagnostic Value of Neutrophil CD64 in Sepsis Patients in the Intensive Care Unit: A Cross-Sectional Study

Abstract

Little is known about the role of neutrophil CD64 (nCD64) in detecting sepsis early in Asian populations. We examined the cut-off and predictive values of nCD64 for diagnosing sepsis in Vietnamese intensive care units (ICU) patients. A cross-sectional study was conducted at the ICU of Cho Ray Hospital between January 2019 and April 2020. All 104 newly admitted patients were included. Sensitivity (Sens), specificity (Spec), positive and negative predictive values (PPV and NPV), and receiver operating characteristic (ROC) curves were calculated to compare the diagnostic values of nCD64 with those of procalcitonin (PCT) and white blood cell (WBC) for sepsis. The median nCD64 value in sepsis patients was statistically higher than that of non-sepsis patients (3106 [1970–5200] vs. 745 [458–906] molecules/cell, p < 0.001). ROC analysis found that the AUC value of nCD64 was 0.92, which was higher than that of PCT (0.872), WBC (0.637), and nCD64 combined, with WBC (0.906) and nCD64 combined with WBC and PCT (0.919), but lower than that of nCD64 combined with PCT (0.924). With an AUC value of 0.92, the nCD64 index of 1311 molecules/cell-detected sepsis with 89.9% Sens, 85.7% Spec, 92.5% PPV, and 81.1% NPV. nCD64 can be a useful marker for early sepsis diagnosis in ICU patients. nCD64 combined with PCT may improve the diagnostic accuracy.