Original article

Neutrophil reactivity intensity correlates with the SOFA score in adults with sepsis: a cross-sectional study from an Indonesian tertiary hospital

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Abstract

Aim: To assess the correlations of neutrophil reactivity intensity (NEUT-RI) and neutrophil granularity intensity (NEUT-GI) with the Sequential Organ Failure Assessment (SOFA) score in adults with sepsis.

Methods: This cross-sectional study included 52 adult inpatients with sepsis at H. Adam Malik General Hospital, Medan, Indonesia, in September 2025. NEUT-RI and NEUT-GI were measured using a Sysmex XN-1000 haematology analyser, and SOFA scores were obtained from medical records. Associations were analysed using Pearson correlation and linear regression. Receiver-operating-characteristic (ROC) analysis for SOFA ≥6 was exploratory because the cut-off was derived and evaluated in the same sample.

Results: The median age was 56 years (IQR 46–64), 29/52 (55.8%) participants were male, and the median SOFA score was 6 (IQR 4–8). NEUT-RI correlated strongly with the SOFA score (r = 0.819; 95% CI 0.704–0.893; R² = 0.671; p < 0.001) and remained independently associated after adjustment for age, sex, NEUT-GI, and log-transformed leukocyte count (B = 0.370; 95% CI 0.294–0.446; standardised β = 0.82; p < 0.001). Exploratory ROC analysis yielded an in-sample AUC of 0.994 for SOFA ≥6 at a cut-off of 49.9 FI. NEUT-GI was not significantly associated with SOFA (r = 0.068; p = 0.631).

Conclusion: NEUT-RI, but not NEUT-GI, was independently associated with concurrent organ-dysfunction severity in adults with sepsis. Prospective validation is required before clinical application.

Keywords: biomarkers, cross-sectional studies, neutrophils, organ dysfunction scores, sepsis