Platelets to Lymphocytes Ratio in Sepsis

Study Overview
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Brief Summary
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The aim of this study is to compare effectiveness of platelets to lymphocytes ratio (PLR) with procalcitonin as a predictor of sepsis outcome.

Detailed Description
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Sepsis is a rapidly progressive, life-threatening disease. Accurate and expeditious assessment of sepsis is important for early administration of antibiotics and removal of the source of infection. In the 2016 version of the sepsis guidelines (Sepsis-3), the concept of the systemic inflammatory response syndrome has been deleted. Although most patients with sepsis receive intensive management, such as early goal directed therapy (EGDT), in an emergency department (ED), the mortality rate of sepsis has been reported to be greater than 20% to 30%. Many clinicians have studied the usefulness of blood biomarkers such as C-reactive protein, procalcitonin, and lactate for early assessment of sepsis and for prognostication, in order to initiate timeous treatment and to prevent rapid progression to multi-organ failure. Several studies mentioned the advantages of the precursor molecule of calcitonin, namely procalcitonin as a biomarker for sepsis. In recent years, studies have reported that platelets and lymphocytes play critical roles in the inflammatory process. Therefore, the platelet-to-lymphocyte ratio (PLR) a novel inflammatory factor has received research attention recently, as it may act as an indicator of inflammation, in a wide spectrum of diseases, such as myocardial infarction,acute kidney injury (AKI), Based on the findings of previous studies, it is reasonable to speculate the presence of a potential relationship between PLR and mortality for sepsis. Platelet to lymphocytes ratio is defined as the ratio of the absolute platelet count and absolute lymphocyte count.

Official Title
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Comparison Between Platelets to Lymphocytes Ratio and Procalcitonin in Prediction of Sepsis Outcome

Conditions
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Platelets to Lymphocytes Ratio Sepsis

Intervention / Treatment
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* Diagnostic Test: Platelets to lymphocytes ratio and procalcitonin


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Septic patients according to Third International Consensus Definitions for Sepsis with ICU stay more than 24 hours will be included. Exclusion Criteria: Pregnant and women in puerperium. Patients with active hemorrhage Patients with hematological diseases (including bone marrow diseases) and collagen diseases. Patients on corticosteroid therapy or immunosuppressive drugs. Patients who will need immediate surgical interventions. Acute cerebrovascular or coronary syndrome. Patients received blood or platelets transfusion before enrollment in the study.

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Platelets to lymphocytes ratio and procalcitonin<br>Platelets to lymphocytes ratio in patients with sepsis | Diagnostic Test: Platelets to lymphocytes ratio and procalcitonin<br>* Platelets to lymphocytes ratio and procalcitonin in sepsis<br>|
| Procalcitonin group<br>Procalcitonin in patient with sepsis | Diagnostic Test: Platelets to lymphocytes ratio and procalcitonin<br>* Platelets to lymphocytes ratio and procalcitonin in sepsis<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The prediction of 28 days mortality. | Prediction of 28 days mortality in icu patients with sepsis according to change in platlet to lymphocyte ratio | during 28 days from patient admission till patient discharge or death. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of icu stay | number of days that past during patient presence in ICU | throught study comletion, maximum 28 days |