Abstract
BackgroundEvidence suggests that C-reactive protein (CRP), procalcitonin (PCT), and immune cells can predict sepsis severity in adult patients. However, the specific values of these indicators are not consistent in predicting prognosis.MethodsA retrospective study analyzed the medical records of 194 patients based on the concept of sepsis in 2016 (Sepsis 3.0) from January 2017 to December 2019. A comparative analysis of inflammatory factors associated with patients in the sepsis survival and the non-survival group was performed. The concentrations of CRP and PCT, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) were measured. ROC curve was used to assess the diagnosis and analysis of the selected indices of sepsis. According to each index’s cut-off value of the ROC curve, the patients were divided into two groups, and the prognosis was calculated.ResultsAmong the 194 patients, 32 died (16.49%), the median age of the patients was 79 (66.0, 83.3) years, and 118 were male (60.8%). Analysis of related inflammatory indicators showed that CRP, NLR, MLR, PLR, and CRP*PCT in the non-survival group were statistically higher than those in the survival group (all p values were < 0.05). Regression analysis showed that PCT, CRP, NLR, PLR, and CRP*PCT were all independent prognostic factors for patients. The ROC curve results showed that CRP*PCT had the best diagnostic value (AUC = 0.915). The cut-off values of PCT, CRP, NLR, PLR, MLR, and CRP*PCT were 0.25 ng/mL, 85.00 mg/L, 8.66, 275.51, 0.74%, and 5.85 (mg/L)2, respectively. Kaplan-Meier survival estimate showed that patient prognosis between the CRP, PCT, NLR, PLR, and CRP*PCT was statistically different (all values P < 0.05, respectively). However, there was no statistically significant difference in gender and MLR (all values P > 0.05, respectively), grouping based on diagnostic cut-off values.ConclusionsIn this study, inflammation-related markers PCT, CRP, NLR, MLR, PLR, and CRP*PCT can be used as independent risk factors affecting the prognosis of patients with sepsis. Furthermore, except for MRL, these indicators have cut-off values for predicting patient death.
Highlights
Evidence suggests that C-reactive protein (CRP), procalcitonin (PCT), and immune cells can predict sepsis severity in adult patients
Sepsis is an acute syndrome triggered by an infection that can lead to severe sepsis or septic shock [1,2,3]
Collection of patient baseline data In this study, a retrospective analysis was carried out to collect the medical records of 194 patients with sepsis treated at the Intensive Care Unit (ICU) ward of our hospital from January 1, 2017, to December 29, 2019
Summary
Evidence suggests that C-reactive protein (CRP), procalcitonin (PCT), and immune cells can predict sepsis severity in adult patients. Procalcitonin (PCT) and C-reactive protein (CRP) are the main biomarkers for diagnosing sepsis. PCT levels increase rapidly in the early phase of the systemic inflammatory response caused by a bacterial infection, which can be detected within 2–3 h, and reaches a peak about 12–24 h after infection. CRP has good value in screening critically ill patients, diagnosing infections, and evaluating patient response to antibiotic treatment [10, 11]. As a sensitive indicator of inflammation, CPR detection is quick and convenient, and CRP increase is positively correlated with the severity of infection or inflammation [12, 13]
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