Comparison between the prognostic value of the white blood cell differential count and morphological parameters of neutrophils and lymphocytes in severely injured patients for 7-day in-hospital mortality

Abstract

Context: Current laboratory parameters provide limited information about the prognosis of severely injured patients; therefore, novel laboratory parameters are needed.

Materials and methods: We compared the morphological parameters of neutrophils and lymphocytes, and white blood cell (WBC) differential count between survivors and nonsurvivors within 7 days after admission. Multiple logistic regression analysis was conducted to identify independent prognostic factors for 7-day in-hospital mortality.

Results: Neutrophil cell size was significantly different between survivors and nonsurvivors (p = 0.04), whereas WBC count and differential were not significantly different. Multiple logistic regression showed that neutrophil cell size was a significant predictor of poor outcome.

Conclusions: Neutrophil cell size at admission is a prognostic factor for 7-day in-hospital mortality in severely injured trauma patients, whereas conventional WBC count and differential have no prognostic value.

Keywords::

• Trauma
• neutrophil morphology
• hematology
• prognosis

Acknowledgements

The authors thank Teun van der Naald who is involved in the trauma registry and Hanneke den Breeijen for assistance with the UPOD database.

Declaration of interest

The authors report no conflict of interest.