Abstract
ObjectiveTo measure the ability of a new bioscore to diagnose sepsis in a general critical care population.MethodsThe 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.ResultsThree 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.ConclusionsThis 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-016-0153-5) contains supplementary material, which is available to authorized users.
Highlights
Sepsis and septic shock are pathological conditions impacting a large proportion of patients admitted to the intensive care unit (ICU), and these patients have poor outcomes [1]
The aim of this investigation was to evaluate the ability of an enhanced bioscore, where common clinical biomarkers are combined with other clinical laboratory information, to provide a more reliable diagnosis and prediction tool for sepsis patients
The study combined the most common clinical biomarkers for sepsis at ICU admission and clinical scoring methods to evaluate the possibility of increasing the accuracy of sepsis diagnosis in a general population of a Chinese ICU
Summary
Sepsis and septic shock are pathological conditions impacting a large proportion of patients admitted to the ICU, and these patients have poor outcomes [1]. Sepsis results from a dysregulated host response to infection leading to uncontrolled inflammation and organ dysfunction and potentially a hypotensive. Diagnosis and direct appropriate therapy within the first hours of hospital admission has been shown to have beneficial effects with respect to patient outcome [4]. Diagnostic and treatment delay prolongs hospital length of stay and increases healthcare costs [5, 6]. The availability of an efficient biomarker/evaluation system would be crucial to help diagnose sepsis quickly. Yang et al Ann. Intensive Care (2016) 6:51 information beyond that which is readily available from routine physiologic data and clinical examination” [7]
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