Prognostic value of the bone marrow in severe sepsis/septic shock

Introduction

Peripheral haematological changes are one of the sepsis diagnosis criteria. However, there are only a few studies concerning the effects of severe sepsis/septic shock in bone marrow of the adult patient.

Objectives

Characterise the bone marrow haematological changes in severe sepsis/septic shock patients and to evaluate the prognostic value of the marrow cell differential count (myeloid, lymphoreticular, erythroid series).

Materials and methods

Prospective study of 29 patients with the diagnosis of severe sepsis/septic shock of different etiologies. Age, SAPS II in the first 24 h, organ dysfunctions according to SOFA, organ failure according to Knaus and the final outcome were considered in the present study.

The bone marrow of each patient was studied and a differential count considering the myeloid, lymphoreticular and erythroid series was made. The patients were separated according to final outcome (dead and alive) and the bone marrow differential counts were compared between the two groups applying t Student test.

Results

See Table.

Conclusion

In the present study significant statistical correlation was found between lymphoreticular count and mortality. We can conclude that bone marrow evaluation has had a prognostic value in this patient group.

Table 1