Jump to ContentJump to Main Navigation
Show Summary Details
In This Section

Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

12 Issues per year

IMPACT FACTOR 2016: 3.432

CiteScore 2016: 2.21

SCImago Journal Rank (SJR) 2015: 0.873
Source Normalized Impact per Paper (SNIP) 2015: 0.982

See all formats and pricing
In This Section
Volume 42, Issue 8 (Aug 2004)


High in-hospital mortality of intensive care patients with nucleated red blood cells in blood

Axel Stachon
  • Institute of Clinical Chemistry, Transfusion and Laboratory Medicine, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany
/ Tim Holland-Letz
  • Department of Biometry, Ruhr-University Bochum, Germany
/ Michael Krieg
  • Institute of Clinical Chemistry, Transfusion and Laboratory Medicine, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany
Published Online: 2005-06-01 | DOI: https://doi.org/10.1515/CCLM.2004.151


The detection of nucleated red blood cells (NRBCs) in blood of patients suffering from a variety of severe diseases is known to be highly associated with increased mortality. Blood analyzers to routinely measure NRBC concentrations are now available. However, the diagnostic and prognostic significance of this parameter for intensive care patients has not been evaluated. Using a Sysmex XE-2100 analyzer, NRBC concentrations were determined in blood samples from 421 patients treated in intensive care units (general and accident surgery, cardiothoracic surgery, and internal medicine) of a university hospital. NRBCs were found at least once in 19.2% of all patients. The mortality of NRBC-positive patients (n = 81) was 42.0% (n = 34); this was significantly higher (p < 0.001) than the mortality of NRBC-negative patients (5.9%, n = 340). The NRBC concentration was 115 ± 4 × 106/l (median 40 × 106/l; range 20–2930 × 106/l) at initial detection of NRBCs in the blood. Mortality increased with increasing NRBC concentration and increasing frequency of occurrence. With regard to in-hospital mortality, NRBCs in blood showed sensitivity and specificity of 63.0% and 87.2%, respectively. The detection of NRBCs is highly predictive of death, the odds ratio after adjustment for other laboratory prognostic indicators being 1.01 (p < 0.01) for each increase in the NRBC concentration of +1 × 106/l. NRBCs were detected for the first time, on average, 13 days (median 8 days) before death. The routine analysis of NRBCs in blood is of high prognostic power with regard to in-hospital mortality of critically ill patients. Therefore, this parameter may serve as an early indicator for patients at increased mortality risk.

Keywords: intensive care; mortality; nucleated red blood cells


  • 1

  • 2

  • 3

  • 4

  • 5

  • 6

  • 7

  • 8

  • 9

  • 10

  • 11

  • 12

  • 13

  • 14

  • 15

  • 16

  • 17

About the article

Corresponding author: Dr. A. Stachon, Institute of Clinical Chemistry, Transfusion and Laboratory Medicine, BG-University Hospital Bergmannsheil, Ruhr-University, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany. Phone: +49-234-3020, Fax: +49-234-302-6614, E-mail:

Received: February 2, 2004

Accepted: April 26, 2004

Published Online: 2005-06-01

Published in Print: 2004-08-01

Citation Information: Clinical Chemistry and Laboratory Medicine, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2004.151. Export Citation

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

C. Tantanate and C. Klinbua
International Journal of Laboratory Hematology, 2015, Volume 37, Number 3, Page 341
David B. Nelson, Nicole P. Yost, and F. Gary Cunningham
Obstetrics & Gynecology, 2014, Volume 124, Number 1, Page 40
Sapana Desai, Stephen L. Jones, Krista L. Turner, Jeff Hall, and Laura J. Moore
Surgical Infections, 2012, Volume 13, Number 6, Page 360
D. T. A. Eisenberg, M. G. Hayes, and C. W. Kuzawa
Proceedings of the National Academy of Sciences, 2012, Volume 109, Number 26, Page 10251
Rupen Shah, Subhash Reddy, H. Mathilda Horst, Jerry Stassinopoulos, Jack Jordan, and Ilan Rubinfeld
The American Journal of Surgery, 2012, Volume 203, Number 3, Page 343
Paolo Danise, Mariacaterina Maconi, Fabio Barrella, Anna Di Palma, Daniela Avino, Adele Rovetti, Maria Gioia, and Giovanni Amendola
Clinical Chemistry and Laboratory Medicine (CCLM), 2012, Volume 50, Number 2
Axel Stachon, Reiner Kempf, Tim Holland-Letz, Jochen Friese, Andreas Becker, and Michael Krieg
Clinica Chimica Acta, 2006, Volume 366, Number 1-2, Page 329
C. Thomas Nebe, Herrad Baurmann, Gudrun Kuling, and Heinz Diem
LaboratoriumsMedizin, 2008, Volume 32, Number 6, Page -
Axel Stachon, Tim Holland-Letz, Reiner Kempf, Andreas Becker, Jochen Friese, and Michael Krieg
Clinical Chemical Laboratory Medicine, 2006, Volume 44, Number 8
Axel Stachon, Andreas Becker, Reiner Kempf, Tim Holland-Letz, Jochen Friese, and Michael Krieg
The Journal of Trauma: Injury, Infection, and Critical Care, 2008, Volume 65, Number 3, Page 666

Comments (0)

Please log in or register to comment.
Log in