Outcomes of Bandemia without leukocytosis in the emergency department: A retrospective analysis.

Publication/Presentation Date

8-7-2025

Abstract

BACKGROUND: Bandemia, defined as >10 % immature neutrophil precursor cells, is a recognized marker of infection. While its clinical significance has been demonstrated the context of leukocytosis, the prognostic value of bandemia with normal level of white blood cell count (WBC) is underexplored. This study aimed to evaluate clinical outcomes associated with bandemia in the absence of leukocytosis among emergency department (ED) patients.

METHODS: We conducted a retrospective observational study using de-identified data from the TriNetX Global Collaborative Network, encompassing 143 healthcare organizations across 22 countries. Adult patients (aged 18-90) presenting to the ED with bandemia (ICD-10-CM D72.825) and a normal WBC count (< 10 × 10

RESULTS: A total of 13,785 patients met inclusion criteria. Within seven days of ED presentation, 4.4 % developed sepsis, 2.4 % progressed to severe sepsis, 1.5 % developed bacteremia, and 0.58 % died. The most common presenting symptom was abdominal or pelvic pain (10.7 %). Hospital inpatient or observational care was required in 5.1 % of cases.

CONCLUSION: Bandemia in the absence of leukocytosis is associated with adverse infectious outcomes, particularly sepsis. These findings support the clinical utility of bandemia as an early indicator of infection, even in the setting of a normal WBC count. Incorporating bandemia into diagnostic evaluations may improve detection and outcomes in patients with early sepsis. Prospective studies are needed to validate these findings and assess the utility of automated band count technologies.

Volume

98

First Page

29

Last Page

32

ISSN

1532-8171

Disciplines

Medicine and Health Sciences

PubMedID

40816043

Department(s)

Department of Emergency Medicine Residents, Fellows and Residents

Document Type

Article

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