Combining C‐reactive protein and quick sequential organ failure assessment (qSOFA) to improve prognostic accuracy for sepsis and mortality in adult inpatients: A systematic review

Zacharakis, Alexandra; Ackermann, Khalia; Hughes, Clifford F.; Lam, Vincent; Li, Ling

doi:10.1002/hsr2.1229

Cited by 3 publications

(2 citation statements)

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“…CRP can activate the complement system, recruit leukocytes to the site of inflammation, and mark pathogens for phagocytosis by identifying and binding foreign molecules on the cell walls of pathogens. Combining CRP with the quick sequential organ failure assessment (qSOFA) probably improves the accuracy of qSOFA alone in identifying patients at risk of dying in hospital from sepsis ( Zacharakis et al, 2023 ). In a retrospective study on the posterior reversible encephalopathy syndrome (PRES, one of the radiological manifestations of septic encephalopathy) in 151 patients, both in univariate and multivariate analyses, higher levels of CRP were associated with in-hospital death ( Siebert et al, 2017 ) ( Figure 4 ).…”

Section: Indicators Of Sepsis and Septic Encephalopathymentioning

confidence: 99%

Septic encephalopathy in the elderly – biomarkers of potential clinical utility

Schütze,

Drevets,

Tauber

et al. 2023

Front. Cell. Neurosci.

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Next to acute sickness behavior, septic encephalopathy is the most frequent involvement of the brain during infection. It is characterized by a cross-talk of pro-inflammatory cells across the blood–brain barrier, by microglial activation and leukocyte migration, but not by the entry of infecting organisms into the brain tissue. Septic encephalopathy is very frequent in older persons because of their limited cognitive reserve. The predominant clinical manifestation is delirium, whereas focal neurological signs and symptoms are absent. Electroencephalography is a very sensitive method to detect functional abnormalities, but these abnormalities are not specific for septic encephalopathy and of limited prognostic value. Routine cerebral imaging by computer tomography usually fails to visualize the subtle abnormalities produced by septic involvement of the brain. Magnetic resonance imaging is by far more sensitive to detect vasogenic edema, diffuse axonal injury or small ischemic lesions. Routine laboratory parameters most suitable to monitor sepsis, but not specific for septic encephalopathy, are C-reactive protein and procalcitonin. The additional measurement of interleukin (IL)-6, IL-8, IL-10 and tumor necrosis factor-α increases the accuracy to predict delirium and an unfavorable outcome. The most promising laboratory parameters to quantify neuronal and axonal injury caused by septic encephalopathy are neurofilament light chains (NfL) and S100B protein. Neuron-specific enolase (NSE) plasma concentrations are strongly influenced by hemolysis. We propose to determine NSE only in non-hemolytic plasma or serum samples for the estimation of outcome in septic encephalopathy.

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Section: Indicators Of Sepsis and Septic Encephalopathymentioning

confidence: 99%

Septic encephalopathy in the elderly – biomarkers of potential clinical utility

Schütze,

Drevets,

Tauber

et al. 2023

Front. Cell. Neurosci.

View full text Add to dashboard Cite

show abstract

“…It has demonstrated limited capacity to forecast adverse clinical outcomes in some studies due to its lack of support from laboratory indicators and low sensitivity [ [11] , [12] , [13] ]. Currently, some scholars are attempting to combine the qSOFA score with laboratory indicators to enhance the predictive capability for sepsis prognosis [ 14 , 15 ]. Moreover, it remains necessary to conduct additional research and provide substantiation on the predictive capability of these scoring tools for the prognosis of sepsis [ 16 ].…”

Section: Introductionmentioning

confidence: 99%