Utilizing cell population data for diagnosis and intensive care unit requirement prediction in Fournier gangrene patients

Objectives: It is vital to rapid diagnosis and to determine the intensive care unit (ICU) requirement early to reduce the mortality rate in Fournier gangrene (FG) patients. Cell population data (CPD) are the parameters obtained from complete blood count (CBC) analysis and related to the activation of different leukocyte subgroups. The study aimed to find reliable markers to diagnose and determine the ICU requirement using CPD. Methods: We included 24 patients and 22 healthy controls in the study. CBC analyses were performed by using a Sysmex XN-9000 series hematology analyzer. ROC analyses and group comparisons were performed to evaluate the diagnostic accuracy and prognostic value of CPD parameters in ICU requirements. Results: Statistically significant differences were observed in terms of some CPD values of lymphocytes, neutrophils, and monocytes in patients compared to healthy controls. Neutrophile-Y or reactivity index (Ne-Y or RI) (p=0.004), neutrophile-X or granularity index (Ne-X or GI) (p=0.009), monocyte-X (Mo-X) (p<0.001), and lymphocyte-WY (Ly-WY) (p<0.001) were higher in patients than controls. Ne-Y (RI) (p=0.012), Mo-X (p=0.001), Mo-Y (p=0.022), and Ne-WY (p=0.025) levels were higher in ICU patients than in non-ICU patients. Conclusions: The severity of FG disease can be determined using CPD data. Ne-Y (RI) serves as a novel and reliable biomarker for determining disease severity. In addition, the neutrophile-lymphocyte ratio can be used to rule out FG, especially in combination with other well-known clinical and diagnostic parameters.