Poor prognosis indicated by nucleated red blood cells in peripheral blood is not associated with organ failure of the liver or kidney
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Axel Stachon
Abstract
Background: The appearance of nucleated red blood cells (NRBCs) in peripheral blood is associated with a variety of severe diseases. When NRBCs are detected in blood, this is generally associated with increased mortality.
Methods: In a prospective study, NRBCs and other laboratory parameters were measured daily in the peripheral blood of surgical intensive care patients. The appearance of NRBCs was analyzed in relation to laboratory indicators of organ injury.
Results: A total of 284 surgical intensive care patients were included in this study. The mortality of NRBC-positive patients was 44.0% (40/91). This was significantly higher (p<0.001) than the mortality of NRBC-negative patients (4.2%, 8/193). Mortality increased with the NRBC concentration and the length of the NRBC-positive period. Multiple logistic regression analysis of several other clinical and laboratory risk indicators revealed a significant association between NRBCs and increased mortality, with an odds ratio of 1.95 (95% CI 1.35–2.82; p<0.001) for each increment in NRBC category (0, 1–40, 41–80, 81–240 and >240NRBC/μL). After the initial detection of NRBCs in blood, there were no significant increases in creatinine concentrations or alanine aminotransferase activity. However, the appearance of NRBCs coincided with increasing C-reactive protein and thrombocyte concentrations.
Conclusions: The detection of NRBCs in blood of surgical intensive care patients is of prognostic power with regard to patient mortality. This prognostic significance of NRBCs was independent of some clinical and other laboratory risk parameters. The appearance of NRBCs in blood was not associated with kidney failure or lesion of the liver.
Clin Chem Lab Med 2006;44:955–61.
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©2006 by Walter de Gruyter Berlin New York
Articles in the same Issue
- Laboratory medicine in the 2000s: programmed death or rebirth?
- Polymorphisms of the inflammatory system and risk of ischemic cerebrovascular events
- Haptoglobin polymorphism in patients with preeclampsia
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- Evaluation of the analytical performance of the advanced method for cardiac troponin I for the AxSYM platform: comparison with the old method and the Access system
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- SIBioC 2006 38th National Congress of the Italian Society of Clinical Biochemistry and Clinical Molecular Biology, Turin, Italy, September 19–22, 2006
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Articles in the same Issue
- Laboratory medicine in the 2000s: programmed death or rebirth?
- Polymorphisms of the inflammatory system and risk of ischemic cerebrovascular events
- Haptoglobin polymorphism in patients with preeclampsia
- Fifteen polymorphisms in endothelin-1, endothelin-2 and endothelin-receptor-A genotyped by four duplex assays and seven simple assays on a LightCycler using hybridization probes
- Optimization of an enzymatic method for the determination of lysosomal N-acetyl-β-D-hexosaminidase and β-glucuronidase in synovial fluid
- An improved laboratory protocol to assess subarachnoid haemorrhage in patients with negative cranial CT scan
- Association of aminothiols with the clinical outcome in hemodialysis patients: comparison of chromatography and immunoassay for homocysteine determination
- Poor prognosis indicated by nucleated red blood cells in peripheral blood is not associated with organ failure of the liver or kidney
- Detection of citrate overdose in critically ill patients on citrate-anticoagulated venovenous haemofiltration: use of ionised and total/ionised calcium
- Unchanged androgen-binding properties of sex hormone-binding globulin in male patients with liver cirrhosis
- Relationship between serum uric acid, creatinine, albumin and gestational diabetes mellitus
- Aminothiols in human brain tumors
- Measurement of carnitine in hemodialysis patients – adaptation of an enzymatic photometric method for an automatic analyzer
- A robust liquid chromatography tandem mass spectrometry method for total plasma homocysteine determination in clinical practice
- Establishment of reference distributions and decision values for thyroid antibodies against thyroid peroxidase (TPOAb), thyroglobulin (TgAb) and the thyrotropin receptor (TRAb)
- Effects of a long-distance run on cardiac markers in healthy athletes
- α-Tocopherol supplementation reduces the elevated 8-hydroxy-2-deoxyguanosine blood levels induced by training in basketball players
- Influence of the needle bore size used for collecting venous blood samples on routine clinical chemistry testing
- The ratio of apoB/apoAI, apoB and lipoprotein(a) are the best predictors of stable coronary artery disease
- Evaluation of the analytical performance of the advanced method for cardiac troponin I for the AxSYM platform: comparison with the old method and the Access system
- Preliminary performance evaluation of blood gas analyzers
- A cost-effectiveness evaluation of reticulocyte measurement in new outpatients with or without hematologic disorders
- Guidelines for setting up an External Quality Assessment Scheme for blood smear interpretation. Part II: survey preparation, statistical evaluation and reporting
- Free light chain testing in follow-up of multiple myeloma
- Blood reactive oxygen metabolites (ROMs) and total antioxidant status (TAS) in patients with laryngeal squamous cell carcinoma after surgical treatment
- SIBioC 2006 38th National Congress of the Italian Society of Clinical Biochemistry and Clinical Molecular Biology, Turin, Italy, September 19–22, 2006
- Third Santorini Biologie Prospective Conference 2006: From Human Genetic Variations to Prediction of Risks and Responses to Drugs and the Environment, Santorini Island, Greece, September 29 - October 2, 2006
