Abstract
IntroductionSepsis biomarkers can have important diagnostic, therapeutic, and prognostic functions. In a previous review, we identified 3370 references reporting on 178 different biomarkers related to sepsis. In the present review, we evaluate the progress in the research of sepsis biomarkers.MethodsUsing the same methodology as in our previous review, we searched the PubMed database from 2009 until September 2019 using the terms “Biomarker” AND “Sepsis.” There were no restrictions by age or language, and all studies, clinical and experimental, were included.ResultsWe retrieved a total of 5367 new references since our previous review. We identified 258 biomarkers, 80 of which were new compared to our previous list. The majority of biomarkers have been evaluated in fewer than 5 studies, with 81 (31%) being assessed in just a single study. Apart from studies of C-reactive protein (CRP) or procalcitonin (PCT), only 26 biomarkers have been assessed in clinical studies with more than 300 participants. Forty biomarkers have been compared to PCT and/or CRP for their diagnostic value; 9 were shown to have a better diagnostic value for sepsis than either or both of these biomarkers. Forty-four biomarkers have been evaluated for a role in answering a specific clinical question rather than for their general diagnostic or prognostic properties in sepsis.ConclusionsThe number of biomarkers being identified is still increasing although at a slower rate than in the past. Most of the biomarkers have not been well-studied; in particular, the clinical role of these biomarkers needs to be better evaluated.
Highlights
Sepsis biomarkers can have important diagnostic, therapeutic, and prognostic functions
Details related to the methodology used in each study were collected, namely (1) type of study, (2) study population, (3) number of studied subjects, (4) reference non-sepsis population, and (5) purpose of study or use of biomarker being tested
The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool [9] was used to assess the methodological quality of the studies that included more than 300 patients and performed receiver operating characteristic (ROC) analysis
Summary
Sepsis biomarkers can have important diagnostic, therapeutic, and prognostic functions. We identified 3370 references reporting on 178 different biomarkers related to sepsis. We evaluate the progress in the research of sepsis biomarkers. Biomarkers have been evaluated for several applications in patients with sepsis including diagnosis of infection, prognostication, and therapeutic guidance. In 2010, we published a literature review of biomarkers that had been studied for their potential diagnostic or prognostic role in sepsis [8]. Pierrakos et al Critical Care (2020) 24:287 practice” [8] In this narrative review, we evaluate the progress that has been made in identifying new sepsis biomarkers since that report and reappraise the utility of such research in the management of patients with sepsis
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