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Combination of C-reactive protein, procalcitonin and sepsis-related organ failure
score for the diagnosis of sepsis in critical patients
#MMPMID27287669
Yang Y
; Xie J
; Guo F
; Longhini F
; Gao Z
; Huang Y
; Qiu H
Ann Intensive Care
2016[Dec]; 6
(1
): 51
PMID27287669
show ga
OBJECTIVE: To measure the ability of a new bioscore to diagnose sepsis in a
general critical care population. METHODS: The study was done at an intensive
care unit (ICU) from April to December 2012. Demographic and clinical patient
information were recorded on admission to the ICU with blood samples taken for
C-reactive protein (CRP), procalcitonin (PCT), interleukin-6, white blood cell
count, as well as body temperature, age and the sepsis-related organ failure
(SOFA) score. These parameters were used to create a scoring system. The scoring
system then underwent analysis by univariate analysis and multivariate logistic
regression analysis to identify which of these clinical parameters were
statistically different in septic versus non-septic patients. The bioscore was
then tested in a receiver operator characteristic curve to determine statistical
significance of the scoring systems ability to predict sepsis. Finally, a
bioscore cutoff value was defined to provide a level for sepsis diagnosis.
RESULTS: Three hundred patients were enrolled, of which 107 patients were septic
and 193 patients were non-septic. Univariate logistic regression showed that age,
gender, CRP, PCT and SOFA were risk factors for occurrence of sepsis.
Multivariate analysis revealed CRP (AUC 0.729, 95 % CI 0.671-0.787, P < 0.001),
PCT (AUC 0.711, 95 % CI 0.652-0.770, P < 0.001) and SOFA (AUC 0.670, 95 % CI
0.607-0.733, P < 0.001) to be statistically significant. The combination of these
values in the bioscore had an AUC of 0.790 (95 % CI 0.739-0.834, P < 0.001). A
bioscore of ?2.65 was considered to be statistically significant in making a
positive diagnosis of sepsis. CONCLUSIONS: This bioscore using CRP, PCT and SOFA
score may potentially be used in the future to help identify septic patients
earlier, improving their access to timely treatment modalities.
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