Early identification of sepsis and mortality risks through simple, rapid clot-waveform analysis

Toh, Cheng Hock; Ticknor, Lawrence O.; Downey, Colin; Giles, Alan R.; Paton, Ray; Wenstone, Richard

doi:10.1007/s00134-002-1557-2

Cited by 63 publications

(73 citation statements)

References 18 publications

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“…However, these studies have focused on changes that occur following the onset of sepsis. Few have examined changes in biomarker expression in a patient population prior to the onset of sepsis (23,37,39). Since the nature of the host response that leads to sepsis is highly complex (8), it is likely that any presymptomatic diagnostic test will have to utilize a set of parameters rather than one specific biomarker.…”

mentioning

confidence: 99%

Presymptomatic Prediction of Sepsis in Intensive Care Unit Patients

Lukaszewski

Yates

Jackson

et al. 2008

Clin Vaccine Immunol

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Postoperative or posttraumatic sepsis remains one of the leading causes of morbidity and mortality in hospital populations, especially in populations in intensive care units (ICUs). Central to the successful control of sepsis-associated infections is the ability to rapidly diagnose and treat disease. The ability to identify sepsis patients before they show any symptoms would have major benefits for the health care of ICU patients. For this study, 92 ICU patients who had undergone procedures that increased the risk of developing sepsis were recruited upon admission. Blood samples were taken daily until either a clinical diagnosis of sepsis was made or until the patient was discharged from the ICU. In addition to standard clinical and laboratory parameter testing, the levels of expression of interleukin-1␤ (IL-1␤), IL-6, IL-8, and IL-10, tumor necrosis factor-␣, FasL, and CCL2 mRNA were also measured by real-time reverse transcriptase PCR. The results of the analysis of the data using a nonlinear technique (neural network analysis) demonstrated discernible differences prior to the onset of overt sepsis. Neural networks using cytokine and chemokine data were able to correctly predict patient outcomes in an average of 83.09% of patient cases between 4 and 1 days before clinical diagnosis with high sensitivity and selectivity (91.43% and 80.20%, respectively). The neural network also had a predictive accuracy of 94.55% when data from 22 healthy volunteers was analyzed in conjunction with the ICU patient data. Our observations from this pilot study indicate that it may be possible to predict the onset of sepsis in a mixed patient population by using a panel of just seven biomarkers.

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mentioning

confidence: 99%

Presymptomatic Prediction of Sepsis in Intensive Care Unit Patients

Lukaszewski

Yates

Jackson

et al. 2008

Clin Vaccine Immunol

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“…These CRP/ VLDL complexes highly correlate with the presence of (pre-) disseminated intravascular coagulation (DIC), elevated D-dimer levels and high mortality rate [15,26]. Taking into consideration that a significant number of patients with low-grade DIC show normal or short aPTT values [3], short aPTT values may be associated with the presence of CRP/VLDL complexes.…”

Section: Discussionmentioning

confidence: 98%

Subjects with a shortened activated partial thromboplastin time show increased in‐hospital mortality associated with elevated D‐dimer, C‐reactive protein and glucose levels

Boekel

Kieviet²,

Bartels³

2003

Scandinavian Journal of Clinical and Laboratory Investigation

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These results suggest that PAI-1 4G/5G and t-PA I/D polymorphisms determine plasma D-dimer levels in patients with shortened aPTT values. Preliminary results show that, among patients with short aPTTs, homozygosity for the hyperfibrinolytic PAI-1 5G or tPA I alleles are at increased risk of in-hospital mortality compared with 4G/4G PAI-1 and D/D tPA homozygotes (OR=2.6, 95% CI: 1.3-5.5 and OR=5.5, 95% CI: 1.3-24.5, respectively).

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“…In addition, difficulties in contacting patients' legal representatives could result in delays to the commencement of antibiotic treatment. Outcomes have been shown to be worse in septic patients when antibiotics were delayed 10,32,33 and so in most instances these patients were excluded.…”

Section: Reliability Of Data Collection Methodsmentioning

confidence: 99%

A pilot randomised controlled trial in intensive care patients comparing 7 days’ treatment with empirical antibiotics with 2 days’ treatment for hospital-acquired infection of unknown origin.

Scawn

Saul²,

Pathak³

et al. 2012

Health Technol Assess

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An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTAA pilot randomised controlled trial in intensive care patients comparing 7 days' treatment with empirical antibiotics with 2 days' treatment for hospital-acquired infection of unknown origin NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The H...

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Early identification of sepsis and mortality risks through simple, rapid clot-waveform analysis

Cited by 63 publications

References 18 publications

Presymptomatic Prediction of Sepsis in Intensive Care Unit Patients

Presymptomatic Prediction of Sepsis in Intensive Care Unit Patients

Subjects with a shortened activated partial thromboplastin time show increased in‐hospital mortality associated with elevated D‐dimer, C‐reactive protein and glucose levels

A pilot randomised controlled trial in intensive care patients comparing 7 days’ treatment with empirical antibiotics with 2 days’ treatment for hospital-acquired infection of unknown origin.

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