Abstract
Objective:Although several biomarkers have been evaluated for the diagnosis and prognosis of sepsis, the gold standard biomarker has not yet been found. We aimed to evaluate the diagnostic value of neutrophil-to-lymphocyte count ratio (NLCR), neopterin, pro-adrenomedullin (pro-ADM) and the other infection markers to predict bacteremia in patients with SIRS, sepsis and severe sepsis/septic shock.Methods:A prospective cohort study was conducted on septic patients in a tertiary referral hospital between December 2014- July 2015. A total of 156 patients diagnosed with SIRS, sepsis and severe sepsis/septic shock in Anesthesia intensive care unit (ICU) were included in the study.Results:A total of 156 patients who had been diagnosed as SIRS(10.9%), sepsis (44.2%) and severe sepsis/septic shock (44.9%) were included. Positive blood cultures were obtained in 64 patients. NLCR, neopterin and pro-ADM levels were insignificant in predicting bacteremia (p>0.05). The mortality rate was significantly higher in bacteremic sepsis (43.9%) compared to non-bacteremic patients (20.8%) (p=0.001). Only procalcitonin levels were significant predictor of mortality (p<0.001).Conclusion:NLCR, CRP, procalcitonin, neopterin and pro-ADM levels were insignificant in diagnosis of bacteremia in critically ill patients. The gold standard method in predicting bacteremia is still blood culture positivity.
Highlights
Sepsis is defined as uncontrolled immune response against the infections and common health problem with increasing incidence in the last two Correspondence: May 19, 2018 August 10, 2018 October 5, 2018 decades.[1]
A total of 156 patients diagnosed with systemic inflammatory response syndrome (SIRS), sepsis and severe sepsis/ septic shock in Anesthesia intensive care units (ICU) were included between December 2014-July 2015
A total of 192 patients admitted to the Anesthesia ICU diagnosed as SIRS, sepsis and severe sepsis/ septic shock were evaluated prospectively during the 2014-2015 study period
Summary
Sepsis is defined as uncontrolled immune response against the infections and common health problem with increasing incidence in the last two Correspondence: May 19, 2018 August 10, 2018 October 5, 2018 decades.[1] It has been reported that more than 650,000 people are affected each year by sepsis.[2] Despite all advances in medicine, it remains a serious clinical problem with an overall mortality of about 30%.3,4. Incidence and mortality rate of sepsis has increased rapidly due to invasive procedures and aggressive treatments especially in intensive care units (ICU).[5].
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