Comparison of the Diagnostic Accuracies of Monocyte Distribution Width, Procalcitonin, and C-Reactive Protein for Sepsis: A Systematic Review and Meta-Analysis

Huang, Yu-Hsuan; Shao, Shih‐Chieh; Li, Chih-Huang; Hsiao, Chien-Han; Niu, Kuang-Yu; Yen, Chieh-Ching

doi:10.1097/ccm.0000000000005820

Cited by 19 publications

(12 citation statements)

References 40 publications

(126 reference statements)

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“…Elevated levels of these markers indicate a heightened inflammatory state that may escalate to sepsis. The underlying mechanism appears to involve an overactive and dysregulated inflammatory response, which is a critical factor in the onset and progression of sepsis [24,25]. Previous research is consistent with our findings, confirming the role of elevated CRP as a predictor of sepsis [4].…”

Section: Discussionsupporting

confidence: 91%

Development of a predictive nomogram for sepsis in patients with urolithiasis-related obstructive pyelonephritis

Tsai,

Huang,

Niu

et al. 2024

Preprint

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Background: In patients with urolithiasis-related obstructive pyelonephritis (UROP), sepsis represents a critical and concerning complication that can substantially increase the mortality rate. This study aimed to identify the risk factors for sepsis in UROP patients and to develop a predictive nomogram model. Methods: We analyzed data from 148 patients who met the UROP criteria and were admitted to Chang Gung Memorial Hospital between January 1, 2016, and December 31, 2021. The primary outcome evaluated was the incidence of sepsis, as defined by the most recent Sepsis-3 guidelines. To identify potential risk factors for sepsis, we employed the Least Absolute Shrinkage and Selection Operator (LASSO) regression technique. Subsequently, we utilized multivariable logistic regression to construct the predictive model. Results: There were a total of 102 non-sepsis cases and 46 sepsis cases. The sepsis group showed significantly lower systolic blood pressure (p < 0.001), a higher heart rate (p = 0.002), a higher shock index (SI) (p < 0.001), a more prevalent history of diabetes mellitus (DM) (p = 0.015), and the mean hospital length of stay was significantly longer (p < 0.001). The laboratory results indicated a higher rate of positive blood culture in the sepsis group (60.9% vs 33.3%, p = 0.002), increased serum white blood cell counts (17.2 ± 10.9 103/uL vs 12.8 ± 6.4 103/uL, p = 0.014), a higher proportion of bandemia (26.1% vs 4.1%, p < 0.001), elevated CRP levels (19.9 ± 9.8 mg/dL vs 9.9 ± 9.9 mg/dL, p < 0.001), and a higher neutrophil to lymphocyte ratio (NLR) (23.6 ± 20.3 vs 12.9 ± 10.1, p < 0.001). Risk factors for sepsis in multivariable analysis were a history of DM (OR = 4.24, p = 0.007), SI (x10-1) (OR = 1.55, p < 0.001), CRP (mg/dL) (OR = 1.08, p = 0.005), and NLR (x10) (OR = 1.58, p = 0.007). Conclusions: Our study demonstrated that patients with UROP who have DM, higher SI, higher NLR, and elevated CRP levels are significantly more likely to develop sepsis. These insights may aid in risk stratification, and it is imperative that clinicians promptly initiate treatment for those identified as high risk.

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Section: Discussionsupporting

confidence: 91%

Development of a predictive nomogram for sepsis in patients with urolithiasis-related obstructive pyelonephritis

Tsai,

Huang,

Niu

et al. 2024

Preprint

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“…This condition may be attributed to high frequency of coronary artery disease in our Turkey. The mortality rate of septic ambulatory patients with DM and no-DM was found to be 35.4% and 35.7%, respectively [19]. However, in the present study, the mortality rate of diabetic septic and non-diabetic septic group was 18.5%, and 11.1% respectively which was not statistically significant (p: 0.063).…”

Section: Discussioncontrasting

confidence: 78%

The role of Asprosin in the diagnosis of diabetic and non-diabetic patients with sepsis

2024

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Sepsis is among the major causes of mortality in the world due to its delayed diagnosis and inadequate treatment. Due to the high morbidity and mortality rates, a widely accepted biomarker is required for its diagnosis. Present study aimed to evaluate the serum asprosin levels in septic patients and determine its potential use as a biomarker for its diagnosis. A prospective cohort study was performed with total 81 participants. These were divided in two groups, i.e., 54 septic patients and 27 healthy volunteers (control group). Among 54 septic participants, half (27) were diabetic, and half (27) were nondiabetic. Blood samples (3 mL) were collected from the control group and the patients who were diagnosed with sepsis and transferred to serum seperator tube. Samples were fractioned and stored at −80 ◦C for further evaluation. These samples were used for the measurement of serum asprosin levels. Demographic characteristics and laboratory data of the patients were recorded in the study form prepared previously. The serum asprosin levels in the control group were 4.1 ± 1.4 ng/mL, 32.8 ± 7 ng/mL in the non-diabetic septic patients and 90.7 ± 5.5 ng/mL in diabetic septic patients. The asprosin level in the non-diabetic group were higher as compared to the control group (p: 0.012), and it was statistically significantly higher in the diabetic group compared to the non-diabetic septic and control groups (both: p < 0.001). Serum asprosin levels were significantly higher in patients with sepsis specially having diabetes. Serum asprosin levels may be beneficial for the diagnosis of sepsis especially in diabetic patients along with the other laboratory parameters white blood cells (WBC), C-reactive protein (CRP), sequential organ failure assessment score (SOFA score) and fewer.

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“…Many studies have been recently carried to investigate the e cient biomarkers for sepsis. As a promising biomarker for sepsis, monocyte distribution width (MDW) had the similar diagnostic accuracy with CPR and PCT, which was suggested to combined other biomarkers to improve its precision [19,20] . Li et al screened and identi ed ApoC3, VCAM1, B2M, and ApoE for septic diagnosis by using proteomic analysis, which was not superior to PCT or CRP.…”

Section: Discussionmentioning

confidence: 99%

The diagnostic value of combined detection based on heparin-binding protein in septic patients

Feng,

Liu,

Wang

et al. 2024

Preprint

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Background Although plenty of biomarkers have been identified, prediction and diagnosis of sepsis is still challenging in the worldwide. As a novel biomarker, heparin-binding protein (HBP) released from neutrophils may induce inflammatory responses and worsen vascular permeability, which presents the physiopathologic characteristics of sepsis and septic shock. We hypothesized that combined measurements based on HBP will enhance the diagnostic efficiency of HBP and is even better than the traditional infection markers. Methods A multi-center observational cohort study between July 2021 and June 2022 at eight tertiary hospitals in Heilongjiang was performed. Enrolled patients were classified into three groups based on infection severity, including non-sepsis, sepsis and septic-shock. Clinical and laboratory data, infection and inflammation biomarkers were collected for analysis. Results A total of 195 patients were enrolled. Of the three groups classified, patients with septic shock (n = 75, 38.5%) had significantly increased levels of HBP, WBC, Lac, CRP, PCT, IL-6, IL-8 and IL-10 compared to non-sepsis (n = 43, 22.0%) and sepsis patients (n = 77, 39.5%) at baseline, as well as 28-d mortality (p < 0.05). Serum concentrations of HBP, Lac, IL-6, IL-8 and IL-10 were remarkably decreased in septic shock patients after 3 d (p < 0.05). Compared to SOFA score and classical markers of CRP, PCT, IL-6 and IL-8, the combined indexes of IL-6·IL-8·HBP and IL-6·IL-8·HBP/ALB showed significantly better performance in the diagnosis of sepsis and septic shock (AUC 0.911 and 0.902 respectively, p < 0.001). Conclusions Combination measurements of IL-6·IL-8·HBP and IL-6·IL-8·HBP/ALB can enhance the diagnostic abilities of HBP for septic diagnosis, and provide early reliable supplements to classical biomarkers for assessment of illness severity in infection patients.

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Comparison of the Diagnostic Accuracies of Monocyte Distribution Width, Procalcitonin, and C-Reactive Protein for Sepsis: A Systematic Review and Meta-Analysis

Cited by 19 publications

References 40 publications

Development of a predictive nomogram for sepsis in patients with urolithiasis-related obstructive pyelonephritis

Development of a predictive nomogram for sepsis in patients with urolithiasis-related obstructive pyelonephritis

The role of Asprosin in the diagnosis of diabetic and non-diabetic patients with sepsis

The diagnostic value of combined detection based on heparin-binding protein in septic patients

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