(1457) Prognostic Ability of Cellular Host Response Test in Serial Monitoring of Suspected Sepsis Patients

Introduction: Sepsis is one of the most impactful conditions facing hospitals. Emergency Department (ED) providers often base the decision to initiate treatment on nonspecific signs of infection. We hypothesized that a test for quantifying the state of immune activation may provide an early indication of the response to therapy. In an observational study, we evaluated the potential prognostic capabilities of serial measurement of the IntelliSep test in adults presenting to the ED who were hospitalized with suspicion of sepsis.

Methods: The IntelliSep test assesses the state of immune activation by measuring leukocyte biophysical properties from whole blood ( < 10 minutes). The test generates the IntelliSep Index (ISI), stratified into 3 interpretation bands based on the probability of sepsis from low (Band 1: 0.1 - 4.9) to high (Band 3: 6.3 - 10.0).

Adults presenting to a Baton Rouge, LA ED in whom blood cultures and antibiotics were ordered were screened, and those admitted to the hospital were prospectively. enrolled. The assay was performed on EDTA-anticoagulated blood daily for up to 7 days or until discharge. Clinical and outcome data were abstracted from the medical record. Sepsis disease status and daily recovery/deterioration assessment were determined by blinded retrospective physician adjudication.

Results: In total 22 patients (sepsis prevalence 77.3%), were stratified based on their initial ISI (day of enrollment) as 3 Band 1, 10 Band 2, and 9 Band 3. Overall, Band 1 patients showed minimal change in ISI over their length of stay; Band 2 patients showed rapid decreases in ISI for days 0-2 (p < .001) into Band 1, and then further, insignificant decline from days 2-6, with a total average drop of 5.6 to 3.7 ISI (p < .0001); Band 3 patients showed rapid declines in ISI over days 0-2 (p < .001) and days 5-6 (p < .05), with a total average drop in ISI from 8.0 to 4.7 (p < .0001). For those in Bands 2 and 3, ISI values trended with daily clinical assessments and were observed to be a leading indicator (~3-5 days) to resolution of organ dysfunction as measured by serial SOFA calculations.

Conclusions: This study indicates serial measurements of the IntelliSep test may aid in disease prognostication in those hospitalized following admission from the ED with suspicion of sepsis.