Early detection of severe sepsis in the emergency room: Diagnostic value of plasma C-reactive protein, procalcitonin, and interleukin-6

The early detection of surgical site infection (SSI) remains an unsolved problem. Inflammatory factors in fluids drained from surgical sites may be a promising tool for predicting SSI. Previous attempts to predict SSI via such factors have not taken baseline concentrations into account. However, this may have comprised predictive efficacy. In the current study, concentrations of C-reactive protein (CRP) and interleukin 6 (IL-6) in fluid samples drained from surgical sites in 20 patients with SSI and 60 matched controls were assessed, and concentrations from day 2 to day 4 were divided by the concentration at day 1 to achieve concentration standardization. There were no significant differences of CRP or IL-6 concentrations at day 1 or day 2 ( p > 0.05), but there were significant differences at day 3 and day 4 ( p < 0.05). The areas under the curve (AUCs) for SSI of standardized concentrations were higher than those of the corresponding absolute concentrations of CRP and IL-6 in fluid drained at days 3 and 4. Standardized concentrations of CRP at day 4 yielded the highest AUC (0.92; 95% confidence interval: 0.84–0.97), with a sensitivity of 90% and specificity of 80% at the best cutoff. Concentration standardization may improve the efficacy of predicting SSI via CRP and IL-6 in fluids drained from surgical sites. Although the sample size was small, the study demonstrated the feasibility of non-invasive, accurate, and early detection of postoperative SSI in a diverse real population. Further studies are needed to validate the results of the present study and investigate their broader applicability. Impact statement The ability to predict surgical site infections (SSIs) early would be advantageous. Previous studies have investigated the use of inflammatory factors in fluids drained from surgical sites to predict SSI, but the diagnostic efficacy of this method requires improvement. Baseline levels of inflammatory factors vary between individuals, but this variation tends to differ in patients with and without SSIs. Therefore, we standardized subsequently acquired concentrations of interleukin 6 and C-reactive protein in fluids drained from surgical sites by dividing them by the concentrations determined at day 1 to preclude the confounding effects of differences in baseline levels. The standardized concentrations had higher predictive efficacy than the absolute concentrations. Standardizing the data rendered SSI prediction more precise and practical in a diverse group of real patients. This translational study suggests that inflammatory factors in fluid drained from injury sites are promising tools for the prediction of SSI in the clinic.

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Prognostic value of the biomarkers procalcitonin, interleukin-6 and C-reactive protein in severe sepsis

Medicina Intensiva (English Edition) ◽

10.1016/j.medine.2012.10.008 ◽

2012 ◽

Vol 36 (8) ◽

pp. 556-562

Author(s):

V. Miguel-Bayarri ◽

E.B. Casanoves-Laparra ◽

L. Pallás-Beneyto ◽

S. Sancho-Chinesta ◽

L.F. Martín-Osorio ◽

...

Keyword(s):

Severe Sepsis ◽

Interleukin 6 ◽

Prognostic Value ◽

C Reactive Protein ◽

Reactive Protein

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Comparison of thrombelastometry with procalcitonin, interleukin 6, and C-reactive protein as diagnostic tests for severe sepsis in critical ill adults

Critical Care ◽

10.1186/cc9284 ◽

2010 ◽

Vol 14 (5) ◽

pp. R178 ◽

Cited By ~ 46

Author(s):

Michael Adamzik ◽

Martin Eggmann ◽

Ulrich H Frey ◽

Klaus Gorlinger ◽

Martina Brocker-PreuSZ ◽

...

Keyword(s):

Severe Sepsis ◽

Interleukin 6 ◽

Diagnostic Tests ◽

C Reactive Protein ◽

Reactive Protein ◽

Ill Adults ◽

Critical Ill

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Leukocytes, C-Reactive Protein and Interleukin-6 in Acute Appendicitis in Children: Diagnostic Value and Association with Histological Findings

Acta Medica Saliniana ◽

10.5457/ams.128.09 ◽

2009 ◽

Vol 0 (In Press) ◽

Author(s):

Nesad Hotic ◽

Elmir Cickusic ◽

Deso Mesic ◽

Edin Husaric ◽

Amir Halilbasic ◽

...

Keyword(s):

Acute Appendicitis ◽

Interleukin 6 ◽

Diagnostic Value ◽

Histological Findings ◽

C Reactive Protein ◽

Reactive Protein

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Clinical Significance of Procalcitonin, C-Reactive Protein, and Interleukin-6 in Helping Guide the Antibiotic Use for Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Disease Markers ◽

10.1155/2021/8879401 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Wen Song ◽

Yue Wang ◽

Fengming Tian ◽

Liang Ge ◽

Xiaoqian Shang ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Interleukin 6 ◽

Antibiotic Use ◽

Diagnostic Value ◽

Chronic Obstructive ◽

C Reactive Protein ◽

Obstructive Pulmonary Disease ◽

Reactive Protein ◽

Acute Exacerbations ◽

Antibiotic Group

Background. Currently, standards of antibiotic use in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients are controversial. Objective. The aim of the present study was to analyze the value of procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6) levels to guide the antibiotic treatment of AECOPD patients. Methods. A total of 371 patients with COPD or AECOPD were included in the study. Clinical and laboratory data were obtained at admission, 325 AECOPD patients and 46 sCOPD patients treated with antibiotics. The receiver operating curve (ROC) was used to evaluate the relationship between CRP, PCT, and IL-6. Results. This study included medical record/case control 1, the COPD group ( n = 46 ) and the AECOPD group ( n = 325 ), and medical record control 2, the nonchanged antibiotic group ( n = 203 ) and the changed antibiotic group ( n = 61 ). In case 1, CRP, PCT, and IL-6 levels in the AECOPD group were higher than that in the control group ( P < 0.05 ), while the result of ROC showed that IL-6 had higher AUC values (0.773) and higher sensitivity (71.7%) than other indicators. The specificity of PCT (93.5%) is higher than other indicators. In case 2, ROC curve results showed that the AUC value of IL-6 (0.771) was slightly higher than PCT and CRP. The sensitivity (85.2%) and specificity (65.5%) of CRP were higher than other indicators. Conclusions. IL-6 and PCT were elevated in AECOPD patients, resulting in a higher diagnostic value for AECOPD. CRP had a higher diagnostic value for antibiotic use in AECOPD patients.

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Usefulness of Presepsin for the Early Detection of Infectious Complications after Elective Colorectal Surgery, Compared with C-Reactive Protein and Procalcitonin

10.21203/rs.3.rs-812361/v1 ◽

2021 ◽

Author(s):

Erika Amanai ◽

Kishiko Nakai ◽

Junichi Saito ◽

Eiji Hashiba ◽

Takuya Miura ◽

...

Keyword(s):

Colorectal Surgery ◽

Early Detection ◽

Postoperative Mortality ◽

Clinical Problem ◽

Diagnostic Value ◽

Infectious Complications ◽

Infected Group ◽

C Reactive Protein ◽

Elective Colorectal Surgery ◽

Reactive Protein

Abstract Background: Infectious complications remain a major clinical problem in colorectal surgery, contributing to prolonged hospital stays, additional costs and significant postoperative mortality. Presepsin has been reported to be a useful marker to diagnose sepsis, similar or superior to procalcitonin (PCT) and C-reactive protein (CRP), and plasma presepsin concentrations are associated with the severity of sepsis and its outcome. The aim of this study was to assess the diagnostic value of presepsin in the early detection of infectious complications after elective colorectal surgery, compared with CRP and PCT.Methods: This study was a prospective observational study. Patients of age >18 who underwent elective colon resections were enrolled and patients with end-stage kidney disease were excluded. Blood samples were collected just before surgery and on postoperative day (POD) 1, 2, 3, 4, and 6. Infectious complications were diagnosed by surgeons. Results: A total of 114 patients were examined, and 27 patients (23.7%) developed infectious complications: 11 anastomotic leaks, 13 intra-abdominal infections, and 3 wound infections. CRP and PCT markedly increased from POD1 to POD3 and then gradually decreased toward POD6 in both groups, but the trends of the decrease in the infected group were blunt, compared with those in the non-infected group. On the other hand, presepsin did not show major changes just after surgery, but it increased on POD4 and POD6, when the complications occurred. ROC analysis to predict infectious complications revealed that the best accuracy was obtained on POD 6 for all biomarkers. CRP showed excellent predictability and presepsin showed good predictability. However, the cut-off values of all biomarkers were relatively lower than expected. Conclusions: The trends of change in presepsin following colorectal surgeries were distinct from those of CRP and PCT. Monitoring the presepsin trends after colorectal surgeries could be helpful to detect postoperative infectious complications.Trial registration: UMIN000025313. Registered on 17 December 2016.

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The Role of C-reactive Protein and Interleukin 6 in the Cases of Preeclampsia Associated with Obesity

Revista de Chimie ◽

10.37358/rc.19.3.7011 ◽

2019 ◽

Vol 70 (3) ◽

pp. 805-808 ◽

Cited By ~ 1

Author(s):

Izabella Petre ◽

Marius Craina ◽

Nicolae Suciu ◽

Alina Sisu ◽

Radu Dumitru Moleriu ◽

...

Keyword(s):

Risk Factor ◽

Early Detection ◽

Pregnant Women ◽

Interleukin 6 ◽

Inflammatory Markers ◽

Inflammatory Condition ◽

European Level ◽

C Reactive Protein ◽

Reactive Protein

In the management of preeclampsia/eclampsia, it would be useful at least at European level, to have clear protocols for early detection and approach of cases with hypertension, as well as to create an algorithm to identify the predisposition to hypertensive pregnancy pathology. The aim has been to identify the favorable factors and the evolution of the pregnancy in the 100 patients admitted to the obstetrics clinic between January 2014 and December 2018, aged between 15-44 years, who have been diagnosed with preeclampsia. In recent years, the management of pregnant women with preeclampsia has improved a lot due to a better understanding of the pathogenesis and a refinement of adequate pregnancy monitoring. Obesity has been shown to be a risk factor in preeclampsia. Several studies have identified preeclampsia as an inflammatory condition. A large number of inflammatory markers, such as C-reactive protein (PCR) and Interleukin 6 (IL-6), have been shown to be elevated in pregnant women with preeclampsia.

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Diagnostic value of resistin and visfatin, in comparison with C-reactive protein, procalcitonin and interleukin-6 in neonatal sepsis

European Cytokine Network ◽

10.1684/ecn.2011.0283 ◽

2011 ◽

Vol 22 (2) ◽

pp. 113-117 ◽

Cited By ~ 17

Author(s):

Ferhat Cekmez ◽

Fuat Emre Canpolat ◽

Merih Çetinkaya ◽

Seçil Aydinöz ◽

Gokhan Aydemir ◽

...

Keyword(s):

Interleukin 6 ◽

Neonatal Sepsis ◽

Diagnostic Value ◽

C Reactive Protein ◽

Reactive Protein

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Prognostic Value And Daily Trend Of Interleukin-6, Neutrophil CD64 Expression, C-Reactive Protein And Lipopolysaccharide-Binding Protein In Critically Ill Patients: Reliable Predictors Of Outcome Or Not?

Journal of Medical Biochemistry ◽

10.1515/jomb-2015-0002 ◽

2015 ◽

Vol 34 (4) ◽

pp. 431-439 ◽

Cited By ~ 8

Author(s):

Dragan Djordjevic ◽

Janko Pejovic ◽

Maja Surbatovic ◽

Jasna Jevdjic ◽

Sonja Radakovic ◽

...

Keyword(s):

Severe Sepsis ◽

Critically Ill ◽

Critically Ill Patients ◽

Interleukin 6 ◽

Prognostic Value ◽

C Reactive Protein ◽

Lipopolysaccharide Binding Protein ◽

Cd64 Expression ◽

Reactive Protein ◽

Lipopolysaccharide Binding

SummaryBackground:Severe sepsis and/or trauma complicated by multiple organ dysfunction syndrome are the leading causes of death in critically ill patients. The aim of this prospective single-centre study was to assess the prognostic value and daily trend of interleukin-6 (IL-6), neutrophil CD64 expression, C-reactive protein (CRP) and lipopolysaccharide-binding protein (LBP) regarding outcome in critically ill patients with severe trauma and/or severe sepsis. Outcome measure was hospital mortality.Methods:One hundred and two critically ill patients admitted to the intensive care unit of a tertiary university hospital were enrolled in this prospective study. Blood samples were collected on admission (day 1), days 2 and 3.Results:CD64 index was 1.6-fold higher on day 1 and 1.78-fold higher on day 2 in non-survivors (p<0.05). The area under the curve (AUC) for the CD64 index on day 1 for outcome was 0.727. At a cut-off level of 2.80 sensitivity was 75% and specificity was 65%. Patients with CD64 index level on day 1 higher than 2.80 had 2.4-fold higher probability of dying. Odds ratio is 2.40; 95% CI 0.60–9.67.Conclusions:CD64 index on day 1 is a fairly good predictor of outcome. AUCs for IL-6, CRP and LBP were < 0.55, suggesting these biomarkers failed to predict outcome.

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