Trends in complete blood count and derived inflammatory indices in ICU patients undergoing percutaneous tracheostomy: a retrospective exploratory study in Italy.

Abstract

Introduction: Inflammatory responses induced by percutaneous dilatational tracheo-stomy (PDT) are underexplored in critical patients. We examined trends in laboratory values in patients after undergoing PDT and their association with mortality.

Material and methods: An analysis of critical patients who underwent PDT was performed. Laboratory values were collected before PDT and at 24, 48, 72, and 96 hours after. Pre-PDT values were divided into tertiles: Low, Medium, and High. Differences between survivors and non-survivors were assessed using appropriate tests. The Aligned Rank Transform (ART) test was used to analyze the tertile-time interaction by outcome. Post-hoc analyses were conducted as necessary. Tertile-outcome associations were evaluated with univariate and multivariate logistic regression, reporting odds ratios (OR) and 95% confidence intervals (95% CI). Survival differences for significant associations were analyzed with the log-rank test. A P-value < 0.05 was considered significant.

Results: 114 patients who underwent PDT were included. ART demonstrated significant interactions with monocytes and the Aggregate Index of Systemic Inflammation (AISI) relating to outcomes. Monocytes in the Low tertile significantly increased over time (P < 0.001). In multivariate analysis, patients in the Medium (OR: 0.323, 95% CI: 0.101-0.937, P = 0.044) and High (OR: 0.287, 95% CI: 0.087-0.847, P = 0.029) tertiles had a lower probability of death compared with the Low tertile. AISI trends in the Low, Medium, and High tertiles were significant (all P < 0.05). The Low tertile consistently increased over time (all pairwise P < 0.05). Multivariate regression indicated that high AISI was associated with outcomes (OR: 0.270, 95% CI: 0.074-0.861, P = 0.034). Log-rank tests for survival were not significant for monocytes or AISI.

Conclusions: Monocyte and AISI trends after PDT may correlate with short-term morta-lity. Routine hematologic indices can be useful for early risk assessment. Further studies are needed to confirm these findings.