Diagnostic utility of the total nucleated cell count for differentiation of septic and sterile peritoneal effusions in dogs

IF 1.2 4区 农林科学 Q3 VETERINARY SCIENCES Veterinary clinical pathology Pub Date : 2024-02-06 DOI:10.1111/vcp.13315
Amy E. DiDomenico, Megan E. Jacob, Devorah M. Stowe, Erika J. Gruber
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Abstract

Background

Rapid and accurate diagnosis of septic peritonitis is critical for initiating appropriate medical and surgical management.

Objectives

The aim of this study was to determine the diagnostic utility of the total nucleated cell count (TNCC), absolute neutrophil count, neutrophil percentage, and total protein (TP) to distinguish septic versus non-septic peritoneal effusions in dogs.

Methods

Electronic medical records were retrospectively searched for peritoneal fluid samples from 2008 to 2018 and classified as septic or non-septic based on bacterial culture and/or cytology results. Receiver operator characteristic curves (ROCs) were used to describe the overall diagnostic utility of each test, with optimal cutpoints analyzed to dichotomize continuous variables. Positive and negative likelihood ratios were calculated at these cutpoints.

Results

A total of 166 unique samples, including 87 septic and 79 non-septic peritoneal effusions, were included. There were no significant differences in dog sex, age, or days hospitalized between groups. Septic effusions had significantly higher TP, TNCC, absolute neutrophil count, and neutrophil percentage compared with non-septic effusions. The area under the curve of the ROC curves was TNCC (0.80), absolute neutrophil count (0.80), neutrophil percentage (0.64), and TP (0.63). For TNCC and absolute neutrophil count, optimal cutoffs were 17.13 × 103 cells/μL and 19.88 × 103 cells/μL, resulting in positive and negative likelihood ratios of 2.39 and 0.28 and 2.85 and 0.28, respectively.

Conclusions

Total nucleated cell counts and absolute neutrophil counts aid in the differentiation of septic and non-septic peritoneal effusions with similar diagnostic utility but are not sufficiently sensitive or specific to use without concurrent microscopic evaluation.

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总核细胞计数对区分狗的化脓性腹腔积液和无菌性腹腔积液的诊断作用。
背景:化脓性腹膜炎的快速和准确诊断对于启动适当的内科和外科治疗至关重要:化脓性腹膜炎的快速准确诊断对于启动适当的内科和外科治疗至关重要:本研究旨在确定总核细胞计数(TNCC)、绝对中性粒细胞计数、中性粒细胞百分比和总蛋白(TP)在区分犬化脓性腹腔积液与非化脓性腹腔积液方面的诊断效用:回顾性检索2008年至2018年的腹腔积液样本电子病历,并根据细菌培养和/或细胞学结果将其分为化脓性和非化脓性腹腔积液。使用受体运算特征曲线(ROC)来描述每种检验的总体诊断效用,并分析最佳切点,对连续变量进行二分。根据这些切点计算阳性和阴性似然比:结果:共纳入了 166 份独特的样本,包括 87 份化脓性腹腔积液和 79 份非化脓性腹腔积液。各组之间在狗的性别、年龄或住院天数方面没有明显差异。与非化脓性腹腔积液相比,化脓性腹腔积液的TP、TNCC、中性粒细胞绝对计数和中性粒细胞百分比均明显较高。ROC曲线的曲线下面积分别为TNCC(0.80)、中性粒细胞绝对计数(0.80)、中性粒细胞百分比(0.64)和TP(0.63)。TNCC和绝对中性粒细胞计数的最佳临界值分别为17.13×103个细胞/μL和19.88×103个细胞/μL,其阳性和阴性似然比分别为2.39和0.28以及2.85和0.28:结论:总有核细胞计数和绝对中性粒细胞计数有助于区分化脓性腹腔积液和非化脓性腹腔积液,具有相似的诊断效用,但如果不同时进行显微镜评估,其敏感性和特异性都不够高。
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来源期刊
Veterinary clinical pathology
Veterinary clinical pathology 农林科学-兽医学
CiteScore
1.70
自引率
16.70%
发文量
133
审稿时长
18-36 weeks
期刊介绍: Veterinary Clinical Pathology is the official journal of the American Society for Veterinary Clinical Pathology (ASVCP) and the European Society of Veterinary Clinical Pathology (ESVCP). The journal''s mission is to provide an international forum for communication and discussion of scientific investigations and new developments that advance the art and science of laboratory diagnosis in animals. Veterinary Clinical Pathology welcomes original experimental research and clinical contributions involving domestic, laboratory, avian, and wildlife species in the areas of hematology, hemostasis, immunopathology, clinical chemistry, cytopathology, surgical pathology, toxicology, endocrinology, laboratory and analytical techniques, instrumentation, quality assurance, and clinical pathology education.
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