Diagnostic Value of Procalcitonin, Interleukin-6, and Interleukin-8 in Critically Ill Patients Admitted with Suspected Sepsis

Background: In this study, we aimed to investigate the diagnostic and prognostic utilities of presepsin and procalcitonin (PCT) in critically ill patients with suspected sepsis, for whom sepsis was diagnosed clinically based on the Survival Sepsis Campaign (SSC) criteria and to compare it with recent criteria of Sepsis-3. Methods: Blood samples for biomarker measurements of presepsin and PCT were drawn on days 1, 3 and 7 of ICU admission in a total of 26 patients. All patients were followed-up until death or discharge. All studied biomarkers were analyzed according to the diagnosis and severity of sepsis and for prognosis (all-cause mortality) at days 1, 3 and 7. Agreement between the diagnosis of clinical sepsis and presepsin or PCT-based sepsis was assessed using Cohen’s kappa Results: Clinical sepsis (based on Sepsis-3) and presepsin or PCT-based sepsis showed poor agreement (Kappa<0.4). Presepsin levels at day1 correlated significantly with mortality (r=0.45, P; 0.02). The diagnostic value of both presepsin and PCT to diagnose sepsis was weak (Area under curve (AUC) <0.75). The overall agreement in sepsis diagnosis was fair to good based on the both clinical criteria (P<0.05, Kappa: 0.5-0.75). More than 80% of patients (N=21) had sepsis based on presepsin upon admission. Both clinical criteria predicated that less than 20% of patients (N=5) had sepsis upon admission. Conclusion: Based on our findings, the overall agreement between the diagnosis of clinical sepsis and presepsin or PCT-based sepsis was poor. Also, our results show that the new Sepsis-3 definitions were accurate and equal to the previous definition of SSC guideline. Although, availability of diagnostic assays is variable in Iran, but, it seems that addition of developing decision tools that utilize biomarkers to help aid the rapid diagnosis of sepsis is necessary and may improve patient outcomes. Keywords: Presepsin, Pro Calcitonin, Sepsis, Diagnosis

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Diagnostic value of procalcitonin and CRP in critically ill patients admitted with suspected sepsis

Journal of Dental Anesthesia and Pain Medicine ◽

10.17245/jdapm.2015.15.3.135 ◽

2015 ◽

Vol 15 (3) ◽

pp. 135 ◽

Cited By ~ 3

Author(s):

Jae-Sik Joen ◽

Sung-Mi Ji

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Diagnostic Value ◽

Suspected Sepsis

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Procalcitonin and Interleukin-6 for predicting culturenegative and culture positive bacterial sepsis in critically ill patients with systemic inflammatory response syndrome

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v15i1.1353 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Mohd Basri Mat Nor ◽

Azrina Md Ralib

Keyword(s):

Systemic Inflammatory Response Syndrome ◽

Inflammatory Response ◽

Critically Ill ◽

Critically Ill Patients ◽

Interleukin 6 ◽

Systemic Inflammatory Response ◽

Bacterial Sepsis ◽

Saps Ii Score ◽

Culture Positive ◽

Culture Negative

Introduction: Differentiation between culture-negative bacterial sepsis (BS), culturepositive BS and non-infectious systemic inflammatory response syndrome (SIRS) among critically ill patients remains a diagnostic challenge to the intensive care unit (ICU) physicians. This study aimed to evaluate the role of procalcitonin (PCT) and interleukin-6 (IL-6) in predicting non-infectious SIRS, culture-negative BS and culture-positive BS in the ICU. Methods: This prospective observational study was conducted in a tertiary ICU in Pahang. The patients were divided into sepsis and non-infectious SIRS based on clinical assessment with or without positive cultures. Patients with positive cultures were further divided into bacteraemia and positive other culture. The PCT and IL-6 were measured daily over the first 3 days. Results: Two hundred and thirty nine consecutive patients diagnosed with SIRS were recruited, of whom 164 (69%) had sepsis. Among sepsis patients, there were 62 (37.8%) culture positive and 102 (62.2%) culture negative. Of these, 27 (16.5%) develop bacteraemia. The most common site of infection was respiratory (34.4%). Post-LSD analyses showed significant difference in the PCT between culture negative sepsis and SIRS (p=0.01); and positive other culture and SIRS (p=0.04). On the other hand IL-6 cannot differentiate between SIRS and negative culture sepsis (p=0.06). Both PCT and IL-6 predicted bacteraemia with an AUC of 0.70 (0.57 to 0.82) and 0.68 (0.53 to 0.70). IL-6 is independently associated with bacteraemia and other culture after adjusting for age, sex, hypertension, SAPS II score and day 1 PCT. Conclusions: Procalcitonin but not Interleukin-6 is able to differentiate SIRS from culture-negative BS. However, IL-6 is independently associated with bacteraemia and other culture.

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Critically Ill vs. Non-Critically Ill Patients With COVID-19 Pneumonia: Clinical Features, Laboratory Findings, and Prediction

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2021.550456 ◽

2021 ◽

Vol 11 ◽

Author(s):

Wandong Hong ◽

Qin Chen ◽

Songzan Qian ◽

Zarrin Basharat ◽

Vincent Zimmer ◽

...

Keyword(s):

Critical Illness ◽

Disease Severity ◽

Critically Ill ◽

Clinical Features ◽

Critically Ill Patients ◽

Interleukin 6 ◽

Discharge Rate ◽

Laboratory Data ◽

Laboratory Findings ◽

Laboratory Parameters

ObjectivesThe objective of this study was to investigate the clinical features and laboratory findings of patients with and without critical COVID-19 pneumonia and identify predictors for the critical form of the disease.MethodsDemographic, clinical, and laboratory data of 63 COVID-19 pneumonia patients were retrospectively reviewed. Laboratory parameters were also collected within 3–5 days, 7–9 days, and 11–14 days of hospitalization. Outcomes were followed up until March 12, 2020.ResultsTwenty-two patients developed critically ill pneumonia; one of them died. Upon admission, older patients with critical illness were more likely to report cough and dyspnoea with higher respiration rates and had a greater possibility of abnormal laboratory parameters than patients without critical illness. When compared with the non-critically ill patients, patients with serious illness had a lower discharge rate and longer hospital stays, with a trend towards higher mortality. The interleukin-6 level in patients upon hospital admission was important in predicting disease severity and was associated with the length of hospitalization.ConclusionsMany differences in clinical features and laboratory findings were observed between patients exhibiting non-critically ill and critically ill COVID-19 pneumonia. Non-critically ill COVID-19 pneumonia also needs aggressive treatments. Interleukin-6 was a superior predictor of disease severity.

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Abdominal compartment syndrome and intra-abdominal hypertension in critically ill patients: diagnostic value of computed tomography

European Radiology ◽

10.1007/s00330-018-5994-x ◽

2019 ◽

Vol 29 (7) ◽

pp. 3839-3846 ◽

Cited By ~ 3

Author(s):

S. Bouveresse ◽

G. Piton ◽

N. Badet ◽

G. Besch ◽

S. Pili-Floury ◽

...

Keyword(s):

Computed Tomography ◽

Compartment Syndrome ◽

Critically Ill ◽

Abdominal Compartment Syndrome ◽

Critically Ill Patients ◽

Diagnostic Value ◽

Abdominal Hypertension ◽

Abdominal Compartment

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Detectable Serum Severe Acute Respiratory Syndrome Coronavirus 2 Viral Load (RNAemia) Is Closely Correlated With Drastically Elevated Interleukin 6 Level in Critically Ill Patients With Coronavirus Disease 2019

Clinical Infectious Diseases ◽

10.1093/cid/ciaa449 ◽

2020 ◽

Vol 71 (8) ◽

pp. 1937-1942 ◽

Cited By ~ 130

Author(s):

Xiaohua Chen ◽

Binghong Zhao ◽

Yueming Qu ◽

Yurou Chen ◽

Jie Xiong ◽

...

Keyword(s):

Viral Load ◽

Severe Acute Respiratory Syndrome ◽

Critically Ill ◽

Critically Ill Patients ◽

Interleukin 6 ◽

Laboratory Data ◽

Specific Class ◽

Sixth Edition ◽

Severity Of The Disease ◽

Detectable Serum

Abstract Background Although the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load in respiratory specimens has been widely used to diagnose coronavirus disease 2019 (COVID-19), it is undeniable that serum SARS-CoV-2 nucleic acid (RNAemia) could be detected in a fraction of COVID-19 patients. However, it is not clear whether testing for RNAemia is correlated with the occurrence of cytokine storms or with the specific class of patients. Methods This study enrolled 48 patients with COVID-19 admitted to the General Hospital of Central Theater Command, People’s Liberation Army, a designated hospital in Wuhan, China. The patients were divided into 3 groups according to the Diagnosis and Treatment of New Coronavirus Pneumonia (sixth edition) guidelines issued by the National Health Commission of China. Clinical and laboratory data were collected, and the serum viral load and interleukin 6 (IL-6) level were determined. Results Analysis of clinical characteristics of 48 cases of COVID-19 showed that RNAemia was diagnosed only in the critically ill group and seemed to reflect the severity of the disease. Furthermore, the level of the inflammatory cytokine IL-6 in critically ill patients increased significantly, almost 10 times that in other patients. More importantly, the extremely high IL-6 level was closely correlated with the detection of RNAemia (R = 0.902). Conclusions Detectable serum SARS-CoV-2 RNA (RNAemia) in patients with COVID-19 was associated with elevated IL-6 concentration and poor prognosis. Because elevated IL-6 may be part of a larger cytokine storm that could worsen outcome, IL-6 could be a potential therapeutic target for critically ill patients with an excessive inflammatory response.

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