Diagnostic and prognostic markers in sepsis

Abstract

Sepsis is a common and serious complication in intensive care unit patients. An important factor in optimizing survival rates in septic patients is the ability to start treatment early in the course of disease; there is, therefore, a need for accurate diagnostic tests. In recent years, there has been a move away from the rather vague and nonspecific signs that were previously used to diagnose sepsis towards the possible adjunctive role of biomarkers. Many biomarkers have been proposed and assessed clinically, but none alone is specific enough to definitively determine diagnosis. The future direction of research is most likely a greater focus on the use of panels or combinations of markers with clinical signs. Some biomarkers may also be useful for prognosis and guiding therapy. Here, the authors will review our changing approaches to sepsis diagnosis and discuss some of the markers that seem most relevant at the present time.

Diagnostic and prognostic value of procalcitonin and sTREM-1 levels in sepsis

“…Group × time P = 0.07 P = 0.2 P = 0.1 in different patient groups, the mortality rate ranged between 22% and 50% (1,5,19). In our study, the mortality rate in the sepsis group was 54.54%.…”

“…It is a useful marker used in the determination of the severity of the infection, the prediction of prognosis, and monitoring the response to the treatment (5,7).…”

Diagnostic and Prognostic Value of Serum Calprotectin in Septic Shock Patients

“…More recently, biological laboratory markers (biomarkers) have been used, ranging from the relatively simple white blood cell count (WBCs) and Creactive protein (CRP) to more complex biomarkers, such as procalcitonin (PCT) or cytokine levels. [11] Importantly, all of these markers are more helpful at ruling out than at ruling in an infection. Virtually, all patients in ICU have some inflammatory response associated with fever at one time or another, but these responses do not all require antibiotic administration.…”

Economic evaluation of procalcitonin-guided antibiotic therapy in acute respiratory infections: a US health system perspective

“…Biomarkers have shown to be very effective in aiding diagnosis and management of hospital patients with suspected systemic bacterial infections, including community-acquired pneumonia (CAP) and sepsis [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Procalcitonin (PCT) is a novel and effective marker of assumed bacterial infections that safely helps guide antibiotic therapy in acute respiratory tract infections (ARI) and sepsis in hospitals [5,[29][30][31][32][33][34][35][36][37][38][39][40].…”

“…The use of PCT supplies caregivers with added information, which, in principle, enables them to improve the selection of patients for treatment, the timing of treatment initiation, and the overall duration of treatment [21,28,32,33,35,[41][42][43][44][45][46][47]. Insofar as caregivers change their care management and treatment strategies in response to the new information (relative to the usual standard course of action), there are implications for changes in outcomes, both in terms of treatment costs and health status [14,33,35].…”