Soluble membrane receptors, interleukin 6, procalcitonin and C reactive protein as prognostic markers in patients with severe sepsis and septic shock

Ríos-Toro, Juan-Jesús; Márquez-Coello, Mercedes; García-Álvarez, José-María; Martín-Aspas, Andrés; Rivera-Fernández, Ricardo; Benito, Ana Sáez de; Girón-González, José A.

doi:10.1371/journal.pone.0175254

Cited by 69 publications

(62 citation statements)

References 60 publications

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“…An increase in presepsin was also noted in AKI patients without sepsis, in line with the finding of Miyoshi and co-workers [89]. It is important to ensure that the correct analytical target is measured; one study described the use of presepsin, but closer inspection revealed that they had actually measured soluble CD14 and not presepsin (soluble CD14 subtype) [90].…”

Section: Adults Icusupporting

confidence: 75%

“…Comparison of sTREM-1 to PCT and CRP for diagnosis of sepsis has been performed, with results suggesting that sTREM-1 may have better performance (AUCs 0.82, 0.77 and 0.72 for sTREM-1, PCT and CRP, respectively) [106]. The authors also hinted at a possible prognostic role for sTREM-1, noting that concentrations were significantly higher in non-survivors compared to survivors, which was corroborated by other work [75,90,103]. In addition to its predictive value, its potential superiority to PCT and CRP was demonstrated by Brenner and co-workers [103].…”

Section: Adults Icusupporting

confidence: 59%

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Biomarkers for Point-of-Care Diagnosis of Sepsis

2020

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Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. In 2017, almost 50 million cases of sepsis were recorded worldwide and 11 million sepsis-related deaths were reported. Therefore, sepsis is the focus of intense research to better understand the complexities of sepsis response, particularly the twin underlying concepts of an initial hyper-immune response and a counter-immunological state of immunosuppression triggered by an invading pathogen. Diagnosis of sepsis remains a significant challenge. Prompt diagnosis is essential so that treatment can be instigated as early as possible to ensure the best outcome, as delay in treatment is associated with higher mortality. In order to address this diagnostic problem, use of a panel of biomarkers has been proposed as, due to the complexity of the sepsis response, no single marker is sufficient. This review provides background on the current understanding of sepsis in terms of its epidemiology, the evolution of the definition of sepsis, pathobiology and diagnosis and management. Candidate biomarkers of interest and how current and developing point-of-care testing approaches could be used to measure such biomarkers is discussed.

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Section: Adults Icusupporting

confidence: 75%

Section: Adults Icusupporting

confidence: 59%

Biomarkers for Point-of-Care Diagnosis of Sepsis

2020

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“…[21][22][23][24][25] The results showed the diagnosis accuracy and specificity of PCT are higher than those of CRP, and both of them have a moderate degree of diagnostic value. Currently, blood culture is the gold standard in the diagnosis of sepsis, but there are some restrictions such as poor sensitivity and longer inspection time.…”

Section: Discussionmentioning

confidence: 99%

“…After obtaining and thorough reviewing the full manuscripts, it was concluded that 58 articles did not meet the inclusion criteria because there were no outcomes or data deficiency (13), subjects were newborn (16), unqualified grouping (21), and unqualified content (8). After obtaining and thorough reviewing the full manuscripts, it was concluded that 58 articles did not meet the inclusion criteria because there were no outcomes or data deficiency (13), subjects were newborn (16), unqualified grouping (21), and unqualified content (8).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

The diagnostic accuracy of procalcitonin and C‐reactive protein for sepsis: A systematic review and meta‐analysis

Tan

Jiang

et al. 2018

J of Cellular Biochemistry

162

113

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Background The objective of this study was to systematically evaluate the clinical value of procalcitonin and C‐reactive protein in the diagnosis of adult patients with sepsis. Method PubMed, Cochrane, Embase, Wanfang, China National Knowledge Infrastructure, and VIP database were searched by the index words to identify the qualified prospective studies, and relevant literature sources were also searched. The most recent research was done in the April 2017. The only languages included were English or Chinese. In the experiment group, patients were diagnosed with sepsis, severe sepsis, or septic shock; in the control group, the patients were of noninfectious origin or a systemic inflammatory response syndrome. The diagnostic accuracy was analyzed by heterogeneity, diagnostic odds ratio (DOR), sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and the summary receiver‐operating characteristic curve. Results At least nine studies were involved in the meta‐analysis with 495 patients in the sepsis group and 873 patients in the nonsepsis group. In terms of the diagnostic accuracy of C‐reactive protein (CRP) for sepsis, the overall area under the summary receiver operator characteristic (SROC) curve was 0.73 (95% confidence interval [CI], 0.69‐0.77), with a sensitivity and specificity of 0.80 (95% CI, 0.63‐0.90) and 0.61 (95% CI, 0.50‐0.72) respectively, and the DOR was 6.89 (95% CI, 3.86‐12.31). In terms of the diagnostic accuracy of procalcitonin (PCT) for sepsis, the overall area under the SROC curve was 0.85 (95% CI, 0.82‐0.88), with a sensitivity and specificity of 0.80 (95% CI, 0.69‐0.87) and 0.77 (95% CI, 0.60‐0.88) respectively, and the DOR was 12.50 (95% CI, 3.65‐42.80). Conclusion In this meta‐analysis, our results together indicate a moderate degree of value of PCT and CRP for the diagnosis of sepsis in adult patients. The diagnosis accuracy and specificity of PCT are higher than those of CRP.

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“…The CRP test is commonly used to indicate the presence of inflammation in many diseases. Many studies have confirmed its sensitivity in demonstrating inflammation after surgery [26–28]. Until now, there is no solid evidence to support its use before surgery, and none of the previous studies investigated its role in urolithiasis diseases.…”

Section: Discussionmentioning

confidence: 99%

Fever and systemic inflammatory response syndrome after retrograde intrarenal surgery: Risk factors and predictive model

Sun

Lai

et al. 2018

The Kaohsiung J of Med Scie

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This paper investigates the characteristics of patients who underwent retrograde intrarenal surgery (RIRS) to determine the predictive factors for post-operative fever and systemic inflammatory response syndrome (SIRS) and to construct a predictive nomogram to help with risk-stratification. A retrospective study of 337 patients who underwent RIRS was performed. Fever and SIRS were defined according to a previous consensus. Multivariate logistic regression coefficients were used to generate nomograms. Post-operative fever was found in 59 patients (17.5%), and SIRS was found in 22 patients (6.5%). Septic shock developed in 2 patients (0.6%). Three patients (0.9%) suffered from obstructive hydronephrosis. By multivariate analysis, concomitant diabetes mellitus (p = 0.015), high pre-operative C-reactive protein (CRP) (p = 0.015), long surgical times (p = 0.007), high stone burden (p = 0.004) and positive stone culture (p = 0.003) were independent risk factors for fever. Only high pre-operative CRP (p = 0.001), long surgical times (p = 0.001) and high stone burden (p = 0.001) were found to significantly affect the occurrence of SIRS. Predictive nomograms were built for fever and SIRS and the c-statistics for the two predictive models were 0.766 and 0.887, respectively. All patients recovered well after proper treatment, which included antipyretics, antibiotics, and inotropic support and nephrostomy when needed. In conclusion, high stone burden, long surgical time, positive stone culture, high pre-operative CRP and the presence of diabetes mellitus was could increase the risk of fever or SIRS after RIRS for kidney stone. The constructed nomograms could help clinicians in evaluating the risk for post-operative infectious complications.

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Soluble membrane receptors, interleukin 6, procalcitonin and C reactive protein as prognostic markers in patients with severe sepsis and septic shock

Cited by 69 publications

References 60 publications

Biomarkers for Point-of-Care Diagnosis of Sepsis

Biomarkers for Point-of-Care Diagnosis of Sepsis

The diagnostic accuracy of procalcitonin and C‐reactive protein for sepsis: A systematic review and meta‐analysis

Fever and systemic inflammatory response syndrome after retrograde intrarenal surgery: Risk factors and predictive model

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