Zimeng Liu1, Juan Chen1, Yongjun Liu1, Xiang Si1, Zhiyi Jiang1, Xuyu Zhang2, Xiangdong Guan3. 1. Surgical Intensive Care Unit, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. 2. Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. Electronic address: sumsxyz@163.com. 3. Surgical Intensive Care Unit, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. Electronic address: carlg@163.net.
Abstract
BACKGROUND: Rapid and accurate prediction for sepsis remains a challenge in surgical intensive care units. Detection of individual biomarkers is often of marginal usefulness, and several biomarkers are difficult to measure in the clinical setting. The aim of this study was to evaluate the diagnostic and prognostic performance of three routine biomarkers, procalcitonin (PCT), B-type natriuretic peptide (BNP), and lymphocyte percentage, as individual or in combination for sepsis in surgical critically ill patients. MATERIALS AND METHODS: Circulating PCT, BNP, and lymphocyte percentage were measured in surgical patients on admission to the intensive care unit. A bioscore system combining these biomarkers was constructed. All studied variables were analyzed according to the diagnosis and clinical outcomes of sepsis. RESULTS: A total of 320 consecutive patients were included in the analysis. One hundred fifty-six patients presented with sepsis. In the patients with sepsis, levels of PCT and BNP increased and lymphocyte percentage decreased. For individual biomarkers, PCT achieved the best area under the curve for the diagnosis of sepsis, whereas the diagnostic performance of the bioscore was better than that of each individual biomarker (area under the curve, 0.914 [95% confidence interval, 0.862-0.951]). Levels of BNP and bioscore increased in nonsurvivors in the entire cohort, but the accuracy of these two variables for mortality prediction was lower than that shown by Acute Physiology and Chronic Health Evaluation II score. Furthermore, bioscore failed to predict outcomes in septic patients. CONCLUSIONS: A simple bioscore combining PCT together with BNP and lymphocyte percentage improves the diagnostic accuracy for sepsis in surgical critically ill patients but fails to predict outcomes in surgical patients with sepsis.
BACKGROUND: Rapid and accurate prediction for sepsis remains a challenge in surgical intensive care units. Detection of individual biomarkers is often of marginal usefulness, and several biomarkers are difficult to measure in the clinical setting. The aim of this study was to evaluate the diagnostic and prognostic performance of three routine biomarkers, procalcitonin (PCT), B-type natriuretic peptide (BNP), and lymphocyte percentage, as individual or in combination for sepsis in surgical critically ill patients. MATERIALS AND METHODS: Circulating PCT, BNP, and lymphocyte percentage were measured in surgical patients on admission to the intensive care unit. A bioscore system combining these biomarkers was constructed. All studied variables were analyzed according to the diagnosis and clinical outcomes of sepsis. RESULTS: A total of 320 consecutive patients were included in the analysis. One hundred fifty-six patients presented with sepsis. In the patients with sepsis, levels of PCT and BNP increased and lymphocyte percentage decreased. For individual biomarkers, PCT achieved the best area under the curve for the diagnosis of sepsis, whereas the diagnostic performance of the bioscore was better than that of each individual biomarker (area under the curve, 0.914 [95% confidence interval, 0.862-0.951]). Levels of BNP and bioscore increased in nonsurvivors in the entire cohort, but the accuracy of these two variables for mortality prediction was lower than that shown by Acute Physiology and Chronic Health Evaluation II score. Furthermore, bioscore failed to predict outcomes in septic patients. CONCLUSIONS: A simple bioscore combining PCT together with BNP and lymphocyte percentage improves the diagnostic accuracy for sepsis in surgical critically ill patients but fails to predict outcomes in surgical patients with sepsis.
Authors: Zhongheng Zhang; Nathan J Smischney; Haibo Zhang; Sven Van Poucke; Panagiotis Tsirigotis; Jordi Rello; Patrick M Honore; Win Sen Kuan; Juliet June Ray; Jiancang Zhou; You Shang; Yuetian Yu; Christian Jung; Chiara Robba; Fabio Silvio Taccone; Pietro Caironi; David Grimaldi; Stefan Hofer; George Dimopoulos; Marc Leone; Sang-Bum Hong; Mabrouk Bahloul; Laurent Argaud; Won Young Kim; Herbert D Spapen; Jose Rodolfo Rocco Journal: J Thorac Dis Date: 2016-09 Impact factor: 2.895
Authors: Saarwaani Vallabhajosyula; Zhen Wang; M Hassan Murad; Shashaank Vallabhajosyula; Pranathi R Sundaragiri; Kianoush Kashani; Wayne L Miller; Allan S Jaffe; Saraschandra Vallabhajosyula Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2020-01-08