Biomarkers Utility for Sepsis Patients Management

Iskandar, Agustin; Susianti, Hani; Anshory, Muhammad; Somma, S Di

doi:10.5772/intechopen.76107

Cited by 3 publications

(1 citation statement)

References 116 publications

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“…Membrane CD14 is a co-receptor for endotoxin, and during systemic immunoinflammatory response, its soluble form is cleaved from immunocompetent cells like monocytes/macrophages (4). Procalcitonin is a 116-amino acid polypeptide precursor of calcitonin released by the C cells of thyroid gland (5).…”

Section: Introductionmentioning

confidence: 99%

Composite bioscore is superior to routine biomarkers and established scoring systems in predicting mortality in adult critically ill patients with secondary sepsis

et al. 2021

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Introduction: Sepsis represent significant global burden, with estimated 48.9 million cases and 11.0 million sepsis-related deaths recently recorded worldwide. Aim of our prospective, observational study was to assess prognostic value of some readily available routine biomarkers: presepsin, procalcitonin, C-reactive protein (CRP), white blood cell (WBC) count, platelet count, mean platelet volume (MPV) and lactate as well as their combination regarding outcome in a cohort of critically ill adult patients with secondary sepsis.Methods: Total of 86 critically ill patients with secondary sepsis due to peritonitis, pancreatitis and severe trauma, admitted to surgical intensive care unit, were enrolled in prospective study. Blood samples for biomarker analysis were collected in three time-points: on admission -1 st day, 3 rd and 5 th day. The Sequential Organ Failure Assessment (SOFA) score, the Simplified Acute Physiology Score (SAPS) II and the Acute Physiology and Chronic Health Evaluation (APACHE) II score were calculated and recorded within the first 24 hours after admission (1 st day). SOFA and SAPS II scores were recorded daily. Primary end-point was hospital mortality. Results:Values of each applied score were, expectedly, significantly higher in nonsurvivors in all timepoints. Regarding investigated parameters, only presepsin levels were significantly higher in nonsurvivors in all time-points; MPV levels on 3 rd and 5 th day; serum lactate levels on 3 th day; CRP levels and WBC count on 5 th day.Clinical accuracy of parameters in predicting lethal outcome was investigated in all time-points. On the 1 st day, apart from all three scores, only presepsin demonstrated statistically significant discriminative power regarding outcome (AUC of 0.670). Apart from SAPS II and SOFA score, on 3 rd day presepsin, MPV and lactate (AUCs of 0.716, 0.667, and 0.642 respectively) and on 5 th day presepsin, MPV, CRP and WBC count (AUCs of 0.790, 0.681, 0.643 and 0.654 respectively) were good predictors of lethal outcome. Composite bioscore (presepsin, MVP and lactate) on 3 rd day had highest AUC of 0.820 in comparison with individual scores and parameters.Independent predictor of lethal outcome on 1 st day was presepsin (p<0.05) and on 3 rd day MPV (p<0.01). Conclusion:Composite bioscore is superior to routine biomarkers and established scoring systems in prediction of mortality in adult critically ill patients with secondary sepsis.Uvod: Sepsa predstavlja značajano globalno opterećenje, sa procenjenih 48.9 miliona slučajeva i 11 miliona smrtnih slučajeva povezanih sa sepsom godišnje širom sveta. Cilj naše prospektivne, opservacione studije je bio da se proceni prognostička vrednost nekih lako dostupnih, rutinskih biomarkera kao što su: presepstin, prokalcitonin, C-reaktivni protein (CRP), broj leukocita, srednji volumen trombocita (MPV) i laktati kao i njihove kombinacije u smislu predviđanja ishoda kod odraslih kritično obolelih pacijenata sa sekundarnom sepsom. Metode: Prospektivnim istraživanjem je obuhvaćeno ukupno 86 krit...

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Section: Introductionmentioning

confidence: 99%

Composite bioscore is superior to routine biomarkers and established scoring systems in predicting mortality in adult critically ill patients with secondary sepsis

et al. 2021

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Monocyte Distribution Width as a predictor of community acquired sepsis in patients prospectively enrolled at the Emergency Department

et al. 2022

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Background Monocyte Distribution Width (MDW), a simple cellular marker of innate monocyte activation, can be used for the early recognition of sepsis. We performed an observational prospective monocentric study to assess the predictive role of MDW in detecting sepsis in a sample of consecutive patients presenting at the Emergency Department. Methods Prospective observational study using demographic and clinical characteristics, past medical history and other laboratory measurements to predict confirmed sepsis using multivariate logistic regression. Results A total of 2724 patients were included in the study, of which 272 (10%) had sepsis or septic shock. After adjusting for known and potential risk factors, logistic regression found the following independent predictors of sepsis: SIRS equal to 1 (OR: 2.32, 1.16–4.89) and 2 or more (OR: 27.8, 14.8–56.4), MDW > 22 (OR: 3.73, 2.46–5.70), smoking (OR: 3.0, 1.22–7.31), end stage renal function (OR: 2.3, 1.25–4.22), neurodegenerative disease (OR: 2.2, 1.31–3.68), Neutrophils ≥ 8.9 × 103/µL (OR: 2.73, 1.82–4.11), Lymphocytes < 1.3 × 103/µL (OR: 1.72, 1.17–2.53) and CRP ≥ 19.1 mg/L (OR: 2.57, 1.63–4.08). A risk score derived from predictive models achieved high accuracy by using an optimal threshold (AUC: 95%; 93–97%). Conclusions The study suggests that incorporating MDW in the clinical decision process may improve the early identification of sepsis, with minimal additional effort on the standard procedures adopted during emergency care.

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