scholarly journals A promising new predictive factor for detecting bowel resection in childhood intussusception: the lymphocyte-C-reactive protein ratio

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bailin Chen ◽  
Jian Cao ◽  
Chengwei Yan ◽  
Chao Zheng ◽  
Jingyu Chen ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Bowel Resection ◽  
Intestinal Resection ◽  
Inflammatory Factors ◽  
C Reactive Protein ◽  
Intestinal Necrosis ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Receiver Operating

Abstract Background The most critical concern for the management of childhood intussusception is bowel resection due to intestinal ischemia and necrosis. The early prediction of this problem is of great importance. We investigated the value of various combinations of inflammatory factors to predict intestinal necrosis and resection. Methods We retrospectively reviewed the medical records of pediatric patients with intussusception who underwent surgical management. During the research period, 47 patients who underwent intestinal resection due to intestinal necrosis and 68 patients who did not undergo intestinal resection were enrolled. We evaluated the diagnostic value of various combinations of inflammatory markers from preoperative laboratory analyses using the receiver operating characteristic (ROC) method. Results In the current cohort, 115 patients underwent operations for intussusception; among them, 47 patients (40.9%) underwent intestinal resections. In the patients with intestinal resection, the neutrophil count(p = 0.013), CRP level(p = 0.002), platelet–lymphocyte ratio (PLR, p = 0.008), NLR (neutrophil–lymphocyte ratio, p = 0.026), and LCR (lymphocyte–CRP ratio, p < 0.001) values were significantly higher than those in the patients without any resection. The receiver operating characteristic (ROC) analysis results showed that the combination of lymphocytic count along with C-reactive protein levels (LCR) demonstrated the highest correlation with intestinal resection due to intussusception compared with other parameters in the patients, with a sensitivity of 0.82 (0.73–0.86) and specificity of 0.80 (0.57–0.94) for the diagnosis of strangulation. Conclusion The preoperative LCR level is a useful marker to predict the need for intestinal resection due to intestinal necrosis in patients with intussusception.

scholarly journals A Promising New Predictive Factor for Detecting Bowel Resection in Childhood Intussusception: Lymphocyte-C Reactive Protein Ratio

2021 ◽  
Author(s):  
Bailin Chenilin Chen ◽  
Jian Cao ◽  
Chengwei Yan ◽  
Chao Zheng ◽  
Jingyu Chen ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Bowel Resection ◽  
Intestinal Resection ◽  
Inflammatory Factors ◽  
C Reactive Protein ◽  
Intestinal Necrosis ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Receiver Operating

Abstract Background: The most critical concern for management of childhood intussusception is the bowel resection due to the intestinal ischemia and necrocis. It is of great importance for early prediction of this problem. We investigate the value of various combinations of inflammatory factors to predict the intestinal necrocis and resection.Methods: We retrospectively reviewed the medical records of pediatric patients with intussusception, which undergone surgical management. During the research period, 47 patients undergone intestinal resection due to intestinal necrocis and 68 patients without intestinal resection were enrolled. We evaluated the diagnostic values of various combination of inflammatory markers from preoperative period laboratory analyses using the receiver operating characteristic (ROC) method.Results: In the current cohort, 115 patients were operated for intussusception, among them, 47 patients (40.9%) undergone intestinal resections. In patients with intestinal resections, neutrophil count(p=0.013), CRP(p=0.002), platelet–lymphocyte ratio(PLR, p=0.008), NLR(neutrophil–lymphocyte ratio, p=0.026), and LCR(lymphocyte–CRP ratio, p<0.001) values were significantly higher than those in the patients without any resections. Receiver operating characteristic (ROC) analysis results showed that the combination of lymphocytic count along with C-reactive protein levels (LCR) demonstrated the highest correlation with intestinal resection due to intussusception compared with other parameters in patients, with sensitivity of 0.82(0.73–0.86) and specifficity of 0.80(0.57–0.94) for the diagnosis of strangulation. Conclusion: The preoperative LCR level is a useful marker to predict the need for intestinal resection due to intestinal necrosis in patients with intussusception.

scholarly journals A Comparison of Eosinopenia and C-Reactive Protein as a Marker of Bloodstream Infections in Critically Ill Patients: A Case Control Study

2009 ◽  
Vol 37 (3) ◽  
pp. 450-456 ◽  
Author(s):  
K. M. Ho ◽  
S. C. Towler
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Bloodstream Infections ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Receiver Operating

Diagnosis of bloodstream infections in critically ill patients is difficult. This case control study involved a total of 22 patients with confirmed bloodstream infections and 44 concurrent controls from an intensive care unit in Western Australia. We aimed to assess whether eosinopenia and C-reactive protein are useful markers of bloodstream infections in critically ill patients. The patients with bloodstream infections had a more severe disease and a longer length of intensive care unit (10.7 vs 4.0 days, P=0.001) and hospital stay (40.9 vs 17.9 days, P=0.015) than the controls. Univariate analyses showed that C-reactive protein (area under the receiver operating characteristic curve 0.847, 95% confidence internal (CI) 0.721 to 0.973), eosinophil counts (area under the receiver operating characteristic curve 0.849, 95% CI 0.738 to 0.961) and fibrinogen concentrations (area under the receiver operating characteristic curve 0.730, 95% CI 0.578 to 0.882) were significant markers of bloodstream infections. C-reactive protein concentration was, however, the only significant predictor in the multivariate analysis (odds ratio 1.21 per 10 mgH increment, 95% CI 1.01 to 1.39, P=0.007). C-reactive protein concentration appears to be a better marker of bloodstream infections than eosinopenia in critically ill patients. A large prospective cohort study is needed to assess whether eosinopenia is useful in addition to C-reactive protein concentrations as a marker of bloodstream infections.

scholarly journals Kesesuaian Nilai C-Reactive Protein dan Procalcitonin dalam Diagnosis Pneumonia Berat pada Anak

Sari Pediatri ◽  
2016 ◽  
Vol 12 (2) ◽  
pp. 78
Author(s):  
Irawati Irawati ◽  
Heda Melinda ◽  
Ponpon S. Idjradinata
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Receiver Operating

Latar belakang. Penyebab pneumonia sulit dibedakan berdasarkan klinis, radiologis, dan pemeriksaan darah rutin, sedangkan pemeriksaan biakan darah memerlukan waktu lama dengan hasil positif 10%-30% kasus. Baku emas biopsi jaringan paru bersifat invasif dan tidak diindikasikan. Procalcitonin merupakan penanda untuk memperkirakan infeksi bakteri dengan sensitivitas dan spesifisitas paling baik.Tujuan Penelitian. Mengetahui kesesuaian C-reactive protein (CRP) dan procalcitonin dalam diagnosis pneumonia berat pada anak, sehingga pemeriksaan CRP dapat digunakan sebagai pengganti procalcitonin.Metode. Penelitian observasional analitik dengan rancangan potong lintang dilakukan di Unit Gawat Darurat dan Rawat Inap Bagian Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Hasan Sadikin Bandung dan Rumah Sakit Umum Cibabat Cimahi pada bulan Mei-Juni 2010. Pemeriksaan CRP dan procalcitonin dilakukan saat didiagnosis pneumonia berat pada 29 anak berusia 2-60 bulan. Analisis statistik menggunakan kurva analisis receiver operating characteristic (ROC) untuk mengetahui nilai CRP yang dapat digunakan untuk memprediksi infeksi bakteri dan analisis keserasian Kappa untuk menguji kesesuaian antara nilai CRP dan procalcitonin.Hasil. Didapatkan cut off point CRP yang dapat digunakan sebagai prediksi infeksi bakteri adalah >8 mg/L dengan sensitivitas 68,2%, spesifisitas 100% dan akurasi 75,9% dan adanya kesesuaian yang baik antara nilai CRP dan procalcitonin, yaitu K=0,508.Kesimpulan. Terdapat kesesuaian nilai CRP dan procalcitonin dalam diagnosis pneumonia berat pada anak, sehingga CRP dapat digunakan untuk menggantikan procalcitonin. (

scholarly journals Diagnostic Accuracy of Procalcitonin Compared to C-Reactive Protein and Interleukin 6 in Recognizing Gram-Negative Bloodstream Infection: A Meta-Analytic Study

2020 ◽  
Vol 2020 ◽  
pp. 1-14 ◽  
Author(s):  
Liying Lai ◽  
Yijie Lai ◽  
Hao Wang ◽  
Liang Peng ◽  
Ning Zhou ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Receiver Operating Characteristic ◽  
Interleukin 6 ◽  
Operating Characteristic ◽  
Clinical Settings ◽  
C Reactive Protein ◽  
Summary Receiver Operating Characteristic ◽  
Gram Negative ◽  
Reactive Protein ◽  
Receiver Operating

Objective. Gram-negative bloodstream infections (GNBSIs), especially those caused by antibiotic-resistant species, have become a public health challenge. Procalcitonin (PCT) showed promising potential in early diagnosis of GNBSI; however, little was known about its performance under different clinical settings. We here systematically assessed the diagnostic accuracy of PCT in recognizing GNBSI and made direct comparisons with C-reactive protein (CRP) and interleukin 6 (IL-6). Methods. PubMed, Embase, ISI Web of Knowledge, and Scopus were searched from inception to March 15th, 2019. Area under the summary receiver operating characteristic curve (AUC), pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated. Hierarchical summary receiver operating characteristic (HSROC) model was used for the investigation of heterogeneity and for comparisons between markers. Results. 25 studies incorporating 50933 suspected BSI episodes were included. Pooled sensitivity and specificity for PCT were 0.71 and 0.76, respectively. The overall AUC was 0.80. The lowest AUCs were found in patients with febrile neutropenia (0.69) and hematological malignancy (0.69). The highest AUC was found in groups using electrochemiluminescence immunoassay (0.87). In direct comparisons, PCT showed better overall performance than CRP with the AUC being 0.85 (95% CI 0.81–0.87) for PCT and 0.78 (95% CI 0.74–0.81) for CRP, but the relative DORs varied with thresholds between PCT and CRP (p<0.001). No significant difference was found either in threshold (p=0.654) or in accuracy (p=0.480) between PCT and IL-6 in diagnosing GNBSI. Conclusions. PCT was helpful in recognizing GNBSI, but the test results should be interpreted carefully with knowledge of patients’ medical condition and should not serve as the only criterion for GNBSI. Further prospective studies are warranted for comparisons between different clinical settings.

scholarly journals Immature granulocyte percentage for prediction of sepsis in severe burn patients: a machine leaning-based approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kibum Jeon ◽  
Nuri Lee ◽  
Seri Jeong ◽  
Min-Jeong Park ◽  
Wonkeun Song
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Burn Patients ◽  
Severe Burn ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Laboratory Test Results ◽  
Partial Dependence ◽  
Receiver Operating

Abstract Background Of the existing sepsis markers, immature granulocytes (IG) most frequently reflect the presence of an infection. The importance of IG as an early predictor of sepsis and bacteremia is evaluated differently for each study. This study aimed to evaluate the effectiveness of the Sysmex XN series’ IG% as an independent prognostic indicator of sepsis using machine learning. Methods A total of 2465 IG% results from 117 severe burn patients in the intensive care unit of one institution were retrospectively analyzed. We evaluated the IG% for sepsis using the receiver operating characteristic, logistic regression, and partial dependence plot analyses. Clinical characteristics and other laboratory markers associated with sepsis, including WBC, procalcitonin, and C-reactive protein, were compared with the IG% values. Results Twenty-six of the 117 patients were diagnosed with sepsis. The median IG% value was 2.6% (95% CI: 1.4–3.1). The area under the receiver operating characteristic curve was 0.77 (95% CI: 0.78–0.84) and the optimal cut-off value was 3%, with a sensitivity of 76.9% and specificity of 68.1%. The partial dependence plot of IG% on predicting sepsis showed that an IG% < 4% had low predictability, but increased thereafter. The interaction plot of IG% and C-reactive protein showed an increase in sepsis probability at an IG% of 6% and C-reactive protein of 160 mg/L. Conclusions IG% is moderately useful for predicting sepsis. However, since it can be determined from routine laboratory test results and requires no additional intervention or cost, it could be particularly useful as an auxiliary marker.

scholarly journals Combined Analysis of C-reactive Protein in Pleural Fluid and Serum is Effective in the Differential Diagnosis of Exudative Pleural Effusions

2021 ◽  
Author(s):  
Shuo-yao Qu ◽  
Yong Zhang ◽  
Shuo Wu ◽  
Ming-ming Wang ◽  
Ling-li Liu ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Receiver Operating Characteristic ◽  
Pleural Fluid ◽  
Sensitivity And Specificity ◽  
Operating Characteristic ◽  
C Reactive Protein ◽  
Characteristic Analysis ◽  
Combined Analysis ◽  
Reactive Protein ◽  
Receiver Operating

Abstract Background: Exudative pleural effusion (EPE) is one of the common pleural manifestations of various diseases. Differential diagnosis of EPE is imperative clinically as it identifies different causes of EPE, thereby, providing effective treatments. Thoracoscopy is a useful tool for differential diagnosis of EPE. However, some patients would refuse thoracoscopic examination due to its invasive nature. In addition, the specificity and sensitivity of existing routine tests of EPE are less satisfying. Therefore, there is a great need to establish an effective method for differential diagnosis of EPE.Methods: This study was a single-institution retrospective analysis of diagnostic efficiency of C-reactive protein (CRP) and procalcitonin (PCT) between March 2018 and September 2018. Eighty-seven patients diagnosed with EPE were enrolled. All patients underwent diagnostic thoracentesis. And the EPE was examined using biochemical, routine, microbiological, and cytological methods. Pathological cytology detection was of necessity for those with the suspicion of malignant PE. Benign PE comes from patients with pneumonia, empyema and tuberculosis. The levels of CRP and PCT of EPE and serum were measured before the treatment. Correlation analysis and receiver-operating characteristic (ROC) curve analysis were conducted to determine the underlying relationship between levels of CRP and PCT, and differential diagnosis.Results: Receiver operating characteristic analysis showed that the sensitivity and specificity for the analysis of pleural fluid CRP (p-CRP) are higher (cut-off: 17.55 pg/mL; sensitivity: 75.00 %, specificity: 83.90%) than that of serum CRP (s-CRP, cut-off: 23.90 pg/mL; sensitivity: 71.00 %, specificity: 80.4%) in the differential diagnosis for EPE. However, the analysis of pleural fluid PCT (p-PCT) and serum PCT (s-PCT) didn’t demonstrate correlations with EPE. Combined analysis of p-CRP (cut-off: 17.55 mg/dL) with s-CRP (cut-off: 23.9 pg/mL) showed the highest diagnostic accuracy (88.4%) in diagnosing infectious EPE.Conclusions: The data support the close relationship between combined analysis of p-CRP with s-CRP and effective and accurate differential diagnosis of EPE, due to its higher sensitivity and specificity. However, as a highly sensitive marker to diagnose bacterial infections, neither s-PCT nor p-PCT, showed correlations with the differential diagnosis of EPE.

scholarly journals Usefulness of Lymphocyte ratio and CRP Level for Early Detection of Surgical Site Infection Following spinal surgery

2019 ◽  
Author(s):  
Wenbo Wei ◽  
Shajie Dang ◽  
Dapeng Duan ◽  
Liqun Gong ◽  
Jue Wang ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Spinal Surgery ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Site Infection ◽  
C Reactive Protein ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Operating Characteristic Curve

Abstract Background: To investigate the significant laboratory markers for early diagnosis of surgical site infection after spinal surgery. And determine the diagnostic cut-off values of these markers Methods: A total of 67 patients participated in the study: 11 patients who developed surgical site infection after spinal surgery (SSI Group) and 56 patients were compared with the infected group in terms of age，gender, operating time and intraoperative blood loss (Non-SSI Group). The white blood cell (WBC) count , WBC differential , C-reactive protein (CRP) and erythrocyte sedimentation rate(ESR) were determined before and 1, 3 and 7 days postoperatively . Then, we determine the diagnostic cutoff for these markers by using the receiver operating characteristic curve. Results: The CRP, ESR and WBC were significantly higher in the SSI group at 3 and 7 days postoperatively. The lymphocyte ratio at 3 days postoperatively was significantly lower in the SSI Group. Using the receiver operating characteristic curve，lymphocyte ratio <11.5% at 3 days postoperatively (sensitivity 90.9%, specificity 75.4%, area under the curve [AUC] 0.919), and C-reactive protein level >26 mg/dL at 7 days postoperatively (sensitivity 90.9%, specificity 87.7%, area under the curve [AUC] 0.954) were the significant laboratory marker for early detection of SSI Conclusion: Lymphocyte ratio<11.5% at 3 days and C-reactive protein levels>26.5mg/dl at 7 days after spinal surgery are reliable markers of SSI.

scholarly journals Study of C-reactive protein, procalcitonin, and immunocyte ratios in 194 patients with sepsis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tian Tian ◽  
Bing Wei ◽  
Junyu Wang
Keyword(s):  
Roc Curve ◽  
Diagnostic Value ◽  
Inflammatory Factors ◽  
C Reactive Protein ◽  
Patient Death ◽  
Survival Group ◽  
Factors Affecting ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Significant Difference

Abstract Background Evidence suggests that C-reactive protein (CRP), procalcitonin (PCT), and immune cells can predict sepsis severity in adult patients. However, the specific values of these indicators are not consistent in predicting prognosis. Methods A retrospective study analyzed the medical records of 194 patients based on the concept of sepsis in 2016 (Sepsis 3.0) from January 2017 to December 2019. A comparative analysis of inflammatory factors associated with patients in the sepsis survival and the non-survival group was performed. The concentrations of CRP and PCT, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) were measured. ROC curve was used to assess the diagnosis and analysis of the selected indices of sepsis. According to each index’s cut-off value of the ROC curve, the patients were divided into two groups, and the prognosis was calculated. Results Among the 194 patients, 32 died (16.49%), the median age of the patients was 79 (66.0, 83.3) years, and 118 were male (60.8%). Analysis of related inflammatory indicators showed that CRP, NLR, MLR, PLR, and CRP*PCT in the non-survival group were statistically higher than those in the survival group (all p values were < 0.05). Regression analysis showed that PCT, CRP, NLR, PLR, and CRP*PCT were all independent prognostic factors for patients. The ROC curve results showed that CRP*PCT had the best diagnostic value (AUC = 0.915). The cut-off values of PCT, CRP, NLR, PLR, MLR, and CRP*PCT were 0.25 ng/mL, 85.00 mg/L, 8.66, 275.51, 0.74%, and 5.85 (mg/L)2, respectively. Kaplan-Meier survival estimate showed that patient prognosis between the CRP, PCT, NLR, PLR, and CRP*PCT was statistically different (all values P < 0.05, respectively). However, there was no statistically significant difference in gender and MLR (all values P > 0.05, respectively), grouping based on diagnostic cut-off values. Conclusions In this study, inflammation-related markers PCT, CRP, NLR, MLR, PLR, and CRP*PCT can be used as independent risk factors affecting the prognosis of patients with sepsis. Furthermore, except for MRL, these indicators have cut-off values for predicting patient death.

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