An analytical observational study for diagnostic accuracy of volume, conductivity & scatter (VCS) indices of neutrophils for diagnosis of sepsis in an emergency hospital setting

Background & objectives The newer technique using an innovative volume conductivity scatter (VCS) technology is emerging as a surrogate for sepsis diagnosis. The VCS technology offers a more objective method to measure cell volume (V), characterize conductivity (C) and light scatter (S) directly from more than 8,000 white blood cells (WBCs). However, diagnostic performance of VCS parameters in sepsis has not been extensively tested in routine hospital emergency settings. Therefore, the present study aimed to investigate the diagnostic and prognostic performance of VCS markers of neutrophils in our local hospital emergency setting. Methods It was an observational analytical study with 41 cases of sepsis and 43 healthy controls aged above 18 yr. Individuals with acute coronary syndrome and individuals with already diagnosed Human Immunodeficiency Virus (HIV) infection were excluded from the study. Results The mean neutrophil volume (MNV) values were not significantly different between cases and controls (P 0.138) whereas mean neutrophil conductance (MNC) and mean neutrophil scatter (MNS) measurements were significantly higher among cases as compared to controls (both P-values <0.001). According to Receiver Operating Characteristics (ROCs) curve analysis, MNV in our study failed to show statistically significant discriminatory ability in sepsis (AUC 0.54) whereas MNC (AUC 0.98) and MNS (AUC 0.95) showed marked discriminatory ability in diagnosing sepsis in this study cohort. Interpretation & conclusions Among VCS parameters, MNV failed as a standalone biomarker of sepsis in routine emergency setting whereas MNC and MNS had statistically significant diagnostic and discriminatory accuracies among hospitalized affected individuals with sepsis.