Can we find accessible and relevant markers for sepsis outcome?

Abstract Background and Aim: Sepsis is a life-threatening disease with high mortality, therefore establishing early diagnostic and finding reliable prognostic biomarkers is vital. We aimed to investigate the prognostic role, as a single value, of serum procalcitonin, C-reactive protein, serum lactate, platelets number and serum glucose level in septic patients, all measured in the first 24 hours after hospital admittance. Materials and methods: This retrospective study included 241 adult patients with sepsis, severe sepsis or septic shock. We use data from patients observation sheets. Data that were collected include: demographic parameters, comorbidities, necessity of mechanical ventilation and laboratory variables. We performed the statistical analysis with the chi square test for nonparametric data and to analyse the accuracy of prediction we used the receiver - operator curves with the level of significance set at p < 0.05. Results: From 241 patients with a median age of 68 years, 127 (52.69%) were male.113 patients had severe sepsis. 89 patients (36.9%) died and male had an increase mortality rate. Most cases were respiratory sepsis (45.20%). The highest mortality rate was in septic shock (51.2%). Procalcitonin, C-reactive protein and glucose serum level at admittance were not correlated with mortality. The serum levels of creatinine >1.67 mg/dL and serum lactate >1.9 mmol/L at admittance were correlated with mortality (p < 0.01). The cutoff value of 121×103/uL platelets number was also correlated with mortality (p < 0.01). Conclusions: Our findings suggest that serum creatinine, serum lactate and the platelets number could be used as prognostic markers in septic patients at admittance.

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Relation of heart rate variability to serum levels of C-reactive protein in patients with severe sepsis and septic shock

Journal of Critical Care ◽

10.1016/j.jcrc.2008.03.015 ◽

2008 ◽

Vol 23 (2) ◽

pp. 266-267 ◽

Cited By ~ 1

Author(s):

Vasilios Papaioannou ◽

Christos Dragoumanis ◽

Ioannis Pneumatikos

Keyword(s):

Heart Rate ◽

Septic Shock ◽

Heart Rate Variability ◽

Severe Sepsis ◽

Serum Levels ◽

C Reactive Protein ◽

Reactive Protein ◽

Sepsis And Septic Shock

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Procalcitonin and C-Reactive Protein as a Predictor of Organ Dysfunction and Outcome of Sepsis and Septic Shock Patients in Intensive Care Unit

Global Journal of Health Science ◽

10.5539/gjhs.v9n12p169 ◽

2017 ◽

Vol 9 (12) ◽

pp. 169

Author(s):

Syafri Kamsul Arif ◽

Maya P. Suyata ◽

Syafruddin Gaus ◽

Muhammad Ramli Ahmad

Keyword(s):

Septic Shock ◽

Organ Dysfunction ◽

Pearson Correlation ◽

C Reactive Protein ◽

Chi Square ◽

Correlation Test ◽

Positive Correlation ◽

Reactive Protein ◽

Chi Square Test ◽

Sepsis And Septic Shock

BACKGROUND & OBJECTIVE: Sepsis is a potentially life-threatening disorder in ICU. The worst complication is organ dysfunction and mortality. Procalcitonin (PCT) and C-Reactive Protein (CRP) had been proposed as biomarker and predictor for diagnosis, prognosis, and patient deterioration in sepsis and septic shock patients. To know whether PCT and CRP can be used as a predictor of organ dysfunction and outcome in sepsis and septic shock patients in ICU.MATERIALS & METHODS: Data were cohort retrospectively analyzed in 35 sepsis (45.5%) and 42 septic shock patients (54.5%) admitted to ICU Dr. Wahidin Sudirohusodo General Hospital (January 2014 – December 2015). Data were analyzed using Chi-Square test, Pearson Correlation, and Spearman-Rho Correlation test.RESULTS: Total of 77 patients met the inclusion criteria. Cut-off point in predicting organ dysfunction in sepsis and septic shock was significantly higher in PCT (45.7ng/mL) with 76.6% sensitivity and 70.0% specificity, while CRP was 145.75 mg/mL with 70.2% sensitivity and 56.7% specificity. There was a positive correlation of PCT (0.492 [p=0.000]) and CRP (0.336 [p=0.003]) to organ dysfunction reflected on SOFA score using the Pearson Correlation test (p<0.01 statistically significant). Based on Spearman-Rho Correlation test, correlation of PCT (0.191 [p=0.097]) and CRP (0.110 [p=0.340]) to outcome in day-7 was positive but not statistically significant (p≥0.01). While in day-28, there was positive correlation 0.553 (p=0.001) for PCT, 0.460 (p=0.006) for CRP, and statistically significant (p<0.01).CONCLUSIONS: Procalcitonin and CRP can be used as a predictor of organ dysfunction and outcome in sepsis and septic shock patients.

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The C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Patients with Severe Sepsis or Septic Shock Treated with Early Goal-Directed Therapy

PLoS ONE ◽

10.1371/journal.pone.0132109 ◽

2015 ◽

Vol 10 (7) ◽

pp. e0132109 ◽

Cited By ~ 48

Author(s):

Min Hyung Kim ◽

Jin Young Ahn ◽

Je Eun Song ◽

Heun Choi ◽

Hea Won Ann ◽

...

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Independent Predictor ◽

C Reactive Protein ◽

Goal Directed Therapy ◽

Albumin Ratio ◽

Early Goal Directed Therapy ◽

Reactive Protein

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Clinical Usefulness of Procalcitonin and C-Reactive Protein as Outcome Predictors in Critically Ill Patients with Severe Sepsis and Septic Shock

PLoS ONE ◽

10.1371/journal.pone.0138150 ◽

2015 ◽

Vol 10 (9) ◽

pp. e0138150 ◽

Cited By ~ 38

Author(s):

Jeong-Am Ryu ◽

Jeong Hoon Yang ◽

Daesang Lee ◽

Chi-Min Park ◽

Gee Young Suh ◽

...

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Critically Ill ◽

Critically Ill Patients ◽

Clinical Usefulness ◽

Outcome Predictors ◽

C Reactive Protein ◽

Reactive Protein ◽

Sepsis And Septic Shock

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Evaluation of eosinophil count and neutrophil-lymphocyte count ratio versus C-reactive protein levels in patients with sepsis

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174686 ◽

2017 ◽

Vol 5 (11) ◽

pp. 4754

Author(s):

Rahul Khajuria ◽

Vinu Jamwal ◽

Anil K. Gupta ◽

Abhinav Gupta

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Critically Ill Patients ◽

Eosinophil Count ◽

Lymphocyte Count ◽

Sepsis Group ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Count Ratio

Background: One major problem encountered in the intensive care unit is differentiating the inflammatory response from an infective process. Clinical and standard laboratory tests are not very helpful because most critically ill patients develop some degree of inflammatory response, whether or not they have sepsis. Numerous biomarkers have been evaluated to predict mortality in critically ill patients, although none have proved entirely useful. Objective of the study was to evaluate eosinophil count and neutrophil-lymphocyte count ratio with C-reactive protein levels in patients with sepsis.Methods: 71 patients >18 years of age of either sex with a diagnosis of sepsis were enrolled in this one-year observational study. Patients were classified according to the criteria of the American College of Chest Physicians/Society of Critical Care Medicine into sepsis group (n=50) and no sepsis group (n=21). Sepsis group were further divided into subgroups: sepsis (n=19), severe sepsis (n=16) and septic shock (n=15). Absolute eosinophil cell, neutrophil and lymphocyte counts for first 4 consecutive days and then on alternate days up to one week were also noted down. C-reactive protein levels on day 3 were also noted down.Results: In the sepsis group, mean eosinophil count was significantly (p<0.0001) low, mean neutrophil/lymphocyte count ratio was significantly (p<0.0001) high, mean CRP count was significantly (p=0.019) more as compared to that of no sepsis group. Among 16 mortalities, significant (p<0.05) decrease was noted in mean eosinophil count from day 3 onwards in patients of sepsis and septic shock subgroups. Mean N/L ratio showed no significant difference in patients of sepsis, severe sepsis or septic shock. Mean CRP count showed significant (p<0.05) increase in severe sepsis patients and mean Apache II score showed significant (p<0.05) deterioration in patients of septic shock.Conclusions: Neutrophil/lymphocyte count ratio (NLCR) and absolute eosinophil count (AEC) came out as better independent biomarker of sepsis in critically ill patients with infection admitted in intensive care unit. Diagnostic performance was better in these two diagnostic markers as compared to CRP marker. NLCR presented with sensitivity of 89.58%, AEC with 82.35% and CRP with 80.77%. Outcomes of NLCR and AEC were quick, easy and economical in establishing diagnosis of sepsis.

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Serum biomarkers (sTREM-1, procalcitonin, C reactive protein, sCD14, sCD163 and IL-6) as prognostic signs in severe sepsis/septic shock

10.26226/morressier.56d5ba2bd462b80296c96628 ◽

2016 ◽

Author(s):

Juan Jesús Ríos-Toro

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Serum Biomarkers ◽

C Reactive Protein ◽

Reactive Protein

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Relation of heart rate variability to serum levels of C-reactive protein, interleukin 6, and 10 in patients with sepsis and septic shock

Journal of Critical Care ◽

10.1016/j.jcrc.2008.11.010 ◽

2009 ◽

Vol 24 (4) ◽

pp. 625.e1-625.e7 ◽

Cited By ~ 34

Author(s):

Vasilios E. Papaioannou ◽

Christos Dragoumanis ◽

Vasiliki Theodorou ◽

Christos Gargaretas ◽

Ioannis Pneumatikos

Keyword(s):

Heart Rate ◽

Septic Shock ◽

Heart Rate Variability ◽

Interleukin 6 ◽

Serum Levels ◽

C Reactive Protein ◽

Reactive Protein ◽

Sepsis And Septic Shock

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Predictive Factors of Severe Sepsis and Septic Shock in Patients with Hematological Malignancies and Pseudomonas Infections.

Blood ◽

10.1182/blood.v114.22.4552.4552 ◽

2009 ◽

Vol 114 (22) ◽

pp. 4552-4552

Author(s):

Ramzi Jeddi ◽

Hèla Ghédira ◽

Ramzi ben Amor ◽

Lamia Aissaoui ◽

Karima Kacem ◽

...

Keyword(s):

Septic Shock ◽

Multivariate Analysis ◽

Severe Sepsis ◽

Neutrophil Count ◽

Hematological Malignancies ◽

Univariate Analysis ◽

Skin Lesions ◽

Hemoglobin Level ◽

C Reactive Protein ◽

Reactive Protein

Abstract Abstract 4552 Background Pseudomonas aeruginosa is a leading cause of nosocomial infections usually associated with high mortality. The aim of this study was to determine the predictive factors of severe sepsis or septic shock in patients with hematological malignancies and pseudomonas infections. Methods This study was conducted in a teaching hospital (Aziza Othmana University Hospital, Tunis, Tunisia) to evaluate the clinical profile of infections due to Pseudomonas species and to determine risk factors for severe sepsis or septic shock defined according to the criteria of the ACCP/SCCM. Pearson test was used for univariate analysis, and logistic regression for multivariate analysis. Results Between 2004 and 2009,a total of 73 pseudomonas isolates (70 P, aeruginosa) was collected in 60 patients : 47 with acute leukemia (78%), 7 with lymphoma (12%), and 6 with others hematological disorders (10%).The median age was 29 yrs (range, 2-64). Most common sites of the isolates were from bloodstream (45%), and skin lesions (31.5%). At least 11 patients (18%) had 2 or more infections due to Pseudomonas. The most common clinical signs observed were isolated fever (18%), respiratory symptoms (15%), diarrhea (21%), and skin lesions (29%).Susceptibility to major anti-pseudomonas antibiotics revealed that isolates tested were resistant to:piperacillin/tazobactam (40%), cefatazidim (28%), ciprofloxacin (20.5%), imipenem (22%), and amikacin (22%).Severe sepsis or septic shock occurred in 49% of episodes. Crude mortality was (18%, 11 of the 60 patients) all caused by septic shock. In univariate analysis factors associated with severe sepsis or septic shock were: Isolates from more than one site (p=0.04), Absolute neutrophil count < 0.1 × 109/l (p=0.003), concomitant infection with other microorganism (p=0.019), fever lasting for more than 3 days in patients with antibiotherapy (p=0.003), C-reactive protein > 100 mg/l (p <0.0001), serum lactate >2.2 mmol/l (p< 0.0001), serum bicarbonate < 19 mmol/l (p=0.002), hemoglobin level < 70g/l (p<0.0001), renal failure (p=0.006), hypophosphatemia <0.8mmol/l (p=0.003), total bilirubin > 50 μmol/l (p=0.03), and hypoproteinemia <64g/l (p<0.0001). By multivariate analysis, antibiotherapy for more than 3 days (p=0.025,OR=0.217, 95%CI:0.05-0.82), absolute neutrophil count <0.1× 109/l (p=0.046,OR=170;95% CI:1-267), C-reactive protein >100 (p=0.04,OR=15,95%CI: 1,1-219,8), hemoglobin level <70g/l (p=0.037,OR=17,95%CI: 1,1- 243), and hypophosphatemia (p=0.02,OR=148,95%CI:2.2-942) remained as independent predictors of severe sepsis or septic shock. Conclusions This study revealed that several factors such as level of neutrophil count, C-reactive protein, hemoglobin level, severe hypophosphatemia, and antibiotherapy > 72 h before microbiological documentation may play a significant and independent role for the development of severe sepsis/septic shock and increase mortality of Pseudomonas infections in patients with hematological malignancies. Disclosures: No relevant conflicts of interest to declare.

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Qualitative C-reactive protein as a marker of neonatal sepsis in a tertiary neonatal unit in Sudan

Healthcare in Low-resource Settings ◽

10.4081/hls.2013.e21 ◽

2013 ◽

Vol 1 (2) ◽

pp. 21

Author(s):

Abdelmoneim E. Kheir ◽

Ghada A. Jobara ◽

Kamal M. Elhag ◽

Mohamed Z. Karar

Keyword(s):

Risk Factors ◽

Blood Culture ◽

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

University Hospital ◽

C Reactive Protein ◽

Chi Square ◽

Reactive Protein ◽

Chi Square Test ◽

A Prospective Study

Sepsis is one of the most common causes of morbidity and mortality in newborns. Diagnosis of neonatal sepsis may be difficult because clinical presentations are often non-specific. The aim of this study was to evaluate the role of qualitative C-reactive protein in the diagnosis of neonatal sepsis, and examine the correlation between C-reactive protein, blood culture and risk factors for sepsis. This was a prospective study, conducted in the Neonatal Intensive Care Unit at Soba University Hospital, Sudan. A total of seventy babies with a clinical diagnosis of sepsis were included. Chi square test was used to determine the association between C-reactive protein and risk factors for sepsis and also the association between C-reactive protein and blood culture. Blood culture was positive in 41.4% of babies, and C-reactive protein was positive in 58% of babies with positive blood culture. There was significant association between C-reactive protein results and blood culture (P=0.00). In conclusion, we can assume that Creactive protein is a reliable diagnostic marker of neonatal sepsis, especially in developing communities with poor resources.

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