The superiority of 72 h leukocyte descent over CRP for mortality prediction in patients with sepsis

Goldberg, Ilan; Shalmon, Dana; Shteinvil, Ronen; Wasserman, Asaf; Berliner, Shlomo; Levinson, Tal; Shapira, Itzhak; Shenhar‐Tsarfaty, Shani; Meilik, Ahuva; Goldiner, Ilana; Ziv‐Baran, Tomer; Sprecher, Eli; Ritter, Omri; Rogowski, Ori

doi:10.1016/j.cca.2020.12.015

Cited by 4 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast to the results of Goldberg et al, [45] the results of this study showed that WBC < 3.5 × 10 9 /L was a risk factor affecting the prognosis of ICU patients with sepsis. As immune cells and important immune markers in human blood, leukocyte can well resist the invasion of foreign pathogens.…”

Section: Wbc < 35 × 10 9 /Lcontrasting

confidence: 99%

Predictive value of risk factors for prognosis of patients with sepsis in intensive care unit

Chen

Zhang

et al. 2023

Medicine

View full text Add to dashboard Cite

Sepsis has emerged as a major global public health concern due to its elevated mortality and high cost of care. This study aimed to evaluate the risk factors associated with the mortality of sepsis patients in the Intensive Care Unit (ICU), and to intervene in the early stages of sepsis in order to improve patient outcomes and reduce mortality. From January 1st, 2021 to December 31st, 2021, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Huashan Hospital Affiliated to Fudan University, and The Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were designated as sentinel hospitals, and sepsis patients in their respective ICU and Emergency ICU were selected as research subjects, and divided into survivors and non-survivors according to their discharge outcomes. The mortality risk of sepsis patients was subsequently analyzed by logistic regression. A total of 176 patients with sepsis were included, of which 130 (73.9%) were survivors and 46 (26.1%) were non-survivors. Factors identified as having an impact on death among sepsis patients included female [Odds Ratio (OR) = 5.135, 95% confidence interval (CI): 1.709, 15.427, P = .004)], cardiovascular disease (OR = 6.272, 95% CI: 1.828, 21.518, P = .004), cerebrovascular disease (OR = 3.133, 95% CI: 1.093, 8.981, P = .034), pulmonary infections (OR = 6.700, 95% CI: 1.744, 25.748, P = .006), use of vasopressors (OR = 34.085, 95% CI: 10.452, 111.155, P < .001), WBC < 3.5 × 109/L (OR = 9.752, 95% CI: 1.386, 68.620, P = .022), ALT < 7 U/L (OR = 7.672, 95% CI: 1.263, 46.594, P = .027), ALT > 40 U/L (OR = 3.343, 95% CI: 1.097, 10.185, P = .034). Gender, cardiovascular disease, cerebrovascular disease, pulmonary infections, the use of vasopressors, WBC, and ALT are important factors in evaluating the prognostic outcome of sepsis patients in the ICU. This suggests that medical professionals should recognize them expeditiously and implement aggressive treatment tactics to diminish the mortality rate and improve outcomes.

show abstract

Section: Wbc < 35 × 10 9 /Lcontrasting

confidence: 99%

Predictive value of risk factors for prognosis of patients with sepsis in intensive care unit

Chen

Zhang

et al. 2023

Medicine

View full text Add to dashboard Cite

show abstract

“…Consistent with findings of CRP in other settings, 22–24 high pre-implant CRP was associated with increased hospital mortality in patients after LVAD. Besides, the current study indicated that both pre-implant and post-implant CRP is significant predictor of long-term mortality following LVAD implantation.…”

Section: Discussionsupporting

confidence: 86%

C-reactive protein predicts early clinical outcomes and long-term mortality after left ventricular assisted device

et al. 2022

View full text Add to dashboard Cite

Objectives: Left ventricular assist device (LVAD) implantation has become a reliable therapeutic strategy in patients with advanced heart failure. C-reactive protein (CRP) is a well-established biomarker of inflammation. This study aims to determine the prognostic effect of CRP level on clinical outcomes of patients who undergo LVAD implantation. Methods: This is a single-center, observational, retrospective study. One hundred fifty-three patients who received continuous-flow LVAD implantation were included and were divided into two groups of high (>3.9 mg/dL) versus low CRP (⩽3.9 mg/dL). Results: Patients with high pre-implant CRP levels were prone to severe preoperative clinical conditions and complicated intraoperative procedures. Compared with patients in the low CRP group, elevated pre-implant CRP was associated with increased hospital mortality (31.4% vs 8.4%, p < 0.001), postoperative right ventricular failure (47.1% vs 30.1%, p = 0.031), right ventricular assist device use (34.3% vs 16.9%, p = 0.013), AKI (70% vs 51.8%, p = 0.022) and significantly prolonged duration of postoperative mechanical ventilation and intensive care unit length of stay. Univariate Cox regression showed that high pre-implant CRP was significantly associated with increased risk of long-term mortality (Hazard ratio (HR) 2.632 95%; CI: 1.657–4.183, p < 0.001), and multivariable Cox regression also revealed the higher risk of long-term mortality in patients with elevated pre-implant CRP (HR, 2.848 95%CI: 1.659–4.888, p < 0.001). These results remained stable when treating pre-implant CRP as a continuous variable. Besides, the prognostic effect of post-implant CRP was also observed. Conclusions: CRP is a reliable risk-stratification biomarker in patients receiving continuous-flow -LVAD and can be used as a predictor for short- and long-term outcomes.

show abstract

“…Of note, both fibrinogen and CRP represent positive acute phase proteins and may be increased in patients with sepsis. However, CRP was shown to have a poor prognostic accuracy in patients with sepsis within various clinical studies (AUC 0.479) [30]. This may be related to the role of CRP in clearing bacterial and biological debris and tissue healing rather than reflecting disease progression in sepsis or septic shock [31].…”

Section: Discussionmentioning

confidence: 99%

Fibrinogen reflects severity and predicts outcomes in patients with sepsis and septic shock

Schupp

Weidner

Rusnak

et al. 2023

Blood Coagulation &Amp; Fibrinolysis

View full text Add to dashboard Cite

The study investigates the diagnostic and prognostic value of fibrinogen and the albumin-to-fibrinogen-ratio (AFR) in patients with sepsis and septic shock. Limited data regarding the prognostic value of fibrinogen and AFR during the course of sepsis or septic shock are available. Consecutive patients with sepsis and septic shock from 2019 to 2021 were included monocentrically. Blood samples were retrieved from the day of disease onset (day 1), as well as on day 2 and 3. Firstly, the diagnostic value of fibrinogen and the AFR for the diagnosis of a septic shock was tested. Secondly, the prognostic value of fibrinogen and AFR was tested with regard to the 30-day all-cause mortality. Statistical analyses included univariable t-tests, Spearman's correlations, C-statistics, Kaplan-Meier and multivariable Cox regression analyses. Ninety-one patients with sepsis and septic shock were included. With an area under the curve (AUC) of 0.653-0.801, fibrinogen discriminated patients with septic shock from those with sepsis. In the septic shock group, fibrinogen levels were shown to decrease from day 1 to 3 (median decrease 41%). In line, fibrinogen was a reliable predictor for 30-day allcause mortality (AUC 0.661-0.744), whereas fibrinogen levels less than 3.6 g/l were associated with an increased risk of 30-day all-cause mortality (78 vs. 53%; log rank P U 0.004; hazard ratio U 2.073; 95% confidence interval 1.233-3.486; P U 0.006), which was still observed after multivariable adjustment. In contrast, the AFR was no longer associated with the risk of mortality after multivariable adjustment. Fibrinogen was a reliable diagnostic and prognostic tool for the diagnosis of septic shock as well as for 30-day all-cause mortality and superior compared with the AFR in patients admitted with sepsis or septic shock.

show abstract

The superiority of 72 h leukocyte descent over CRP for mortality prediction in patients with sepsis

Cited by 4 publications

References 17 publications

Predictive value of risk factors for prognosis of patients with sepsis in intensive care unit

Predictive value of risk factors for prognosis of patients with sepsis in intensive care unit

C-reactive protein predicts early clinical outcomes and long-term mortality after left ventricular assisted device

Fibrinogen reflects severity and predicts outcomes in patients with sepsis and septic shock

Contact Info

Product

Resources

About