scholarly journals Prognostic value of combining c-reactive protein and quick sequential organ failure assessment for adult inpatients: A systematic review

2021 ◽  
Author(s):  
Alexandra Zacharakis ◽  
Khalia Ackermann ◽  
Clifford Hughes ◽  
Vincent Lam ◽  
Ling Li
Keyword(s):  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Small Sample ◽  
Hospital Environment ◽  
Original Research ◽  
C Reactive Protein ◽  
Eligibility Criteria ◽  
Prognostic Performance ◽  
Reactive Protein ◽  
Failure Assessment

Abstract ObjectiveTo examine the prognostic performance of combining the biomarker c-reactive protein (CRP) with the quick sequential organ failure assessment (qSOFA) bedside tool on mortality prediction in adult inpatients.MethodsWe searched PubMed, MEDLINE, EMBASE, Scopus, Web of Science, Science Direct, CINAHL, Open Grey, Grey Literature Report, and the Clinical Trials registry. Title, abstract, and full text screening were performed by two independent reviewers using pre-determined eligibility criteria. The eligibility criteria were (i) original research, (ii) adult populations, (iii) a comparison between qSOFA and qSOFA combined with CRP, and (iv) set in a hospital environment. The same two reviewers independently extracted data into a pre-designed form and performed a risk of bias assessment using the Quality Assessment tool for Diagnostic Accuracy Studies version 2 (QUADAS-2). Disagreements were settled through discussion and a third reviewer was consulted if necessary. Our primary outcome is mortality.ResultsThree retrospective studies with a total of 1521 patients were included in the review. Adding CRP to qSOFA improved the Area Under the Receiver Operating Characteristic Curve (AUROC) value in all three studies by 3-10%. In the two studies with available data, the addition of CRP improved the sensitivity of qSOFA for mortality risk stratification by 43% and 71%, while decreasing the specificity by 12% and 7% respectively. The cut-off values of CRP ranged from 60 to 128.8mg/L across the three studies. A meta-analysis was not performed due to the heterogeneity across studies and the small sample size.ConclusionsThis comprehensive review provides initial evidence that combining CRP with qSOFA could improve the prognostic performance of qSOFA alone in identifying patients at risk of dying in hospital. The combined tool demonstrates potential to improve patient outcomes, especially in low resource settings. The review also reveals research gaps in this area.RegistrationPROSPERO registration No. CRD42020190973

C-reactive protein with sequential organ failure assessment score: Valuable parameters in managing acute pancreatitis

2014 ◽  
Vol 17 (2) ◽  
pp. 86
Author(s):  
Mohit Bhatia ◽  
DakshaS Nirhale ◽  
VirenderS Athavale ◽  
Murtuza Calcuttawala ◽  
Anirudha Kale ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
C Reactive Protein ◽  
Assessment Score ◽  
Reactive Protein ◽  
Failure Assessment

scholarly journals Accuracy and Prognosis Value of the Sequential Organ Failure Assessment Score Combined With C-Reactive Protein in Patients With Complicated Infective Endocarditis

2021 ◽  
Vol 8 ◽  
Author(s):  
Yaowang Lin ◽  
Shaohong Dong ◽  
Jie Yuan ◽  
Danqing Yu ◽  
Weijie Bei ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
Hospital Death ◽  
C Reactive Protein ◽  
Clinical Predictors ◽  
Characteristic Analysis ◽  
Reactive Protein ◽  
Failure Assessment

This study aimed to evaluate the accuracy and prognostic value of the sequential organ failure assessment (SOFA) score combined with C-reactive protein (CRP) in patients with complicated infective endocarditis (IE). A total of 246 consecutive patients with complicated IE were included in the multicentric prospective observational study. These patients were divided into four groups depending on the SOFA score and CRP optimal cutoff values (≥5 points and ≥17.6 mg/L, respectively), which were determined using the receiver operating characteristic analysis: low SOFA and low CRP (n = 83), low SOFA and high CRP (n = 87), high SOFA and low CRP (n = 25), and high SOFA and high CRP (n = 51). The primary endpoint was in-hospital death, and the secondary endpoint was long-time mortality, defined as subsequent readmission and 3-years mortality in the follow-up period. High SOFA score and high CRP were associated with approximately 29.410% (15/51) of higher incidence of in-hospital death with an area under the curve of 0.872. Multivariate analyses showed that age [odds ratio (OR) = 2.242, 1.142–4.401], neurological failure (Glasgow Coma Scale ≤ 12) (OR = 2.513, 1.041–4.224), Staphylococcus aureus (OR = 2.151, 1.252–4.513), SOFA ≥ 5 (OR = 9.320, 3.621–16.847), and surgical treatment (OR = 0.121, 0.031–0.342) were clinical predictors for in-hospital death. On following up for 12–36 months, SOFA ≥ 5 (p = 0.000) showed higher mortality. A high SOFA score combined with increased CRP levels is associated with in-hospital mortality. Also, SOFA score, but not CRP, predicts long-term mortality in complicated IE.

scholarly journals Diagnostic Accuracy and Prognostic Value of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Septic Patients outside the Intensive Care Unit

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 811
Author(s):  
Silvia Spoto ◽  
Domenica Marika Lupoi ◽  
Emanuele Valeriani ◽  
Marta Fogolari ◽  
Luciana Locorriere ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Diagnostic Accuracy ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Prognostic Value ◽  
Reactive Protein ◽  
Failure Assessment ◽  
Diagnostic Role ◽  
Complete Blood Counts

Background and Objectives: The aim of this study was to evaluate the diagnostic accuracy and prognostic value of neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios and to compare them with other biomarkers and clinical scores of sepsis outside the intensive care unit. Materials and methods: In this retrospective study, 251 patients with sepsis and 126 patients with infection other than sepsis were enrolled. NLR and PLR were calculated as the ratio between absolute values of neutrophils, lymphocytes, and platelets by complete blood counts performed on whole blood by Sysmex XE-9000 (Dasit, Italy) following the manufacturer’s instruction. Results: The best NLR value in diagnosis of sepsis was 7.97 with sensibility, specificity, AUC, PPV, and NPV of 64.26%, 80.16%, 0.74 (p < 0.001), 86.49%, and 53.18%, respectively. The diagnostic role of NLR significantly increases when PLR, C-reactive protein (PCR), procalcitonin (PCT), and mid-regional pro-adrenomedullin (MR-proADM) values, as well as systemic inflammatory re-sponse syndrome (SIRS), sequential organ failure assessment (SOFA), and quick-sequential organ failure assessment (qSOFA) scores, were added to the model. The best value of NLR in predicting 90-day mortality was 9.05 with sensibility, specificity, AUC, PPV, and NPV of 69.57%, 61.44%, 0.66 (p < 0.0001), 28.9%, and 89.9%, respectively. Sensibility, specificity, AUC, PPV, and NPV of NLR increase if PLR, PCR, PCT, MR-proADM, SIRS, qSOFA, and SOFA scores are added to NLR. Conclusions: NLR and PLR represent a widely useful and cheap tool in diagnosis and in predict-ing 90-day mortality in patients with sepsis.

scholarly journals The Quick Sequential Organ Failure Assessment (qSOFA) Score is a Poor Mortality Predictor in Patients with Complicated Intra-abdominal Infections

2020 ◽  
Vol 8 (B) ◽  
pp. 221-225
Author(s):  
Evgeni Dimitrov ◽  
Georgi Minkov ◽  
Emil Enchev ◽  
Krasimira Halacheva ◽  
Yovcho Yovtchev
Keyword(s):  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
University Hospital ◽  
High Morbidity ◽  
Operating Characteristics ◽  
Prognostic Performance ◽  
Prognostic Accuracy ◽  
Failure Assessment ◽  
Abdominal Infections ◽  
Qsofa Score

BACKGROUND: Despite the evolution in surgical treatment and antimicrobial therapy in the last years the complicated intra-abdominal infections (cIAIs) are still associated with high morbidity and mortality. Different scoring systems are already available for early prognostic evaluation and yet none has been widely accepted. AIM: Our aim was to evaluate the prognostic accuracy of quick sequential organ failure assessment (qSOFA), one of the most recent scores, in patients with cIAIs. MATERIALS AND METHODS: We studied retrospectively 110 patients with cIAIs admitted to the Department of Surgical Diseases (DSD) at University Hospital “Prof. Dr. Stoyan Kirkovich” Stara Zagora from January 2017 to July 2019. Area under receiver operating characteristics (AUROC) curves of systemic inflammatory response syndrome (SIRS), qSOFA, and Mannheim Peritonitis Index (MPI) were analyzed and a comparison of ROC curves was performed to explore their prognostic performance. RESULTS: Twenty-five (22.7%) patients died during hospitalization. qSOFA score showed poor prognostic accuracy (AUROC = 0.698, 95% CI = 0.566–0.829), worse than MPI score (AUROC = 0.698 vs. 0.844), but better than SIRS (AUROC = 0.698 vs. 0.583). The qSOFA score ≥2 points was observed with lack of sensitivity (32.0%) as outcome predictor. ROC curve analysis showed prognostic inferiority of qSOFA compared to MPI (difference between areas = 0.146, p = 0.0232). CONCLUSION: In patients with cIAIs, quick-SOFA score was observed with poor prognostic performance.

scholarly journals Demonstration of a Label-Free and Low-Cost Optical Cavity-Based Biosensor Using Streptavidin and C-Reactive Protein

Biosensors ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 4
Author(s):  
Donggee Rho ◽  
Seunghyun Kim
Keyword(s):  
Limit Of Detection ◽  
Point Of Care ◽  
Low Cost ◽  
Optical Cavity ◽  
Sample Volume ◽  
Small Sample ◽  
Label Free ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Cavity Structure

An optical cavity-based biosensor (OCB) has been developed for point-of-care (POC) applications. This label-free biosensor employs low-cost components and simple fabrication processes to lower the overall cost while achieving high sensitivity using a differential detection method. To experimentally demonstrate its limit of detection (LOD), we conducted biosensing experiments with streptavidin and C-reactive protein (CRP). The optical cavity structure was optimized further for better sensitivity and easier fluid control. We utilized the polymer swelling property to fine-tune the optical cavity width, which significantly improved the success rate to produce measurable samples. Four different concentrations of streptavidin were tested in triplicate, and the LOD of the OCB was determined to be 1.35 nM. The OCB also successfully detected three different concentrations of human CRP using biotinylated CRP antibody. The LOD for CRP detection was 377 pM. All measurements were done using a small sample volume of 15 µL within 30 min. By reducing the sensing area, improving the functionalization and passivation processes, and increasing the sample volume, the LOD of the OCB are estimated to be reduced further to the femto-molar range. Overall, the demonstrated capability of the OCB in the present work shows great potential to be used as a promising POC biosensor.

scholarly journals Establishment of a prognostic model based on the Sequential Organ Failure Assessment score for patients with first-time acute myocardial infarction

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110119
Author(s):  
Shuai Zheng ◽  
Jun Lyu ◽  
Didi Han ◽  
Fengshuo Xu ◽  
Chengzhuo Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
Cardiovascular Events ◽  
Failure Assessment ◽  
First Time

Objective This study aimed to identify the prognostic factors of patients with first-time acute myocardial infarction (AMI) and to establish a nomogram for prognostic modeling. Methods We studied 985 patients with first-time AMI using data from the Multi-parameter Intelligent Monitoring for Intensive Care database and extracted their demographic data. Cox proportional hazards regression was used to examine outcome-related variables. We also tested a new predictive model that includes the Sequential Organ Failure Assessment (SOFA) score and compared it with the SOFA-only model. Results An older age, higher SOFA score, and higher Acute Physiology III score were risk factors for the prognosis of AMI. The risk of further cardiovascular events was 1.54-fold higher in women than in men. Patients in the cardiac surgery intensive care unit had a better prognosis than those in the coronary heart disease intensive care unit. Pressurized drug use was a protective factor and the risk of further cardiovascular events was 1.36-fold higher in nonusers. Conclusion The prognosis of AMI is affected by age, the SOFA score, the Acute Physiology III score, sex, admission location, type of care unit, and vasopressin use. Our new predictive model for AMI has better performance than the SOFA model alone.

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