New hematological parameters as early diagnosis and prognostic markers in critically patients

Abstract

INTRODUCTION: Nucleated red blood cells and immature granulocytes are not normally detected in the blood of healthy adults. We aimed to investigate the effect of nucleated red blood cells and immature granulocytes on mortality in order to identify critically ill patients who were admitted to the emergency department, at high risk of death, and who was not traumatic. MATERIAL AND METHODS: This study was performed retrospectively in the emergency department of a tertiary education and research hospital between January 2021 and June 2021. All patients who died out of trauma and patients who were discharged from the emergency department on the same day were included. Nucleated red blood cells and immature granulocytes parameters were compared between the two groups. The primary outcome was all-cause death in the emergency department. RESULTS: Of the 188 patients included in the study, 129 (68.6%) were male. Nucleated red blood cells (1.88 ± 6.9/μL; 0.02 ± 0.08), % immature granulocytes (2.91 ± 3.04/μL; 0.58 ± 1.63) and immature red blood cells in deceased patients’ granulocyte count (0.38 ± 0.46/μL; 0.04 ± 0.04) was significantly more significant than the control group (p < 0.001). When the area under the curve was examined, the highest value was found in nucleated red blood cells (Area under the curve = 0.920, p < 0.001). In multivariate regression analysis, high nucleated red blood cells, immature granulocyte count, and white blood cell levels were associated with all-cause mortality in the emergency department. CONCLUSIONS: High nucleated red blood cells and immature granulocyte levels may be associated with increased mortality during admission to the emergency department.