C-Reactive Protein and Hemogram Parameters for the Non-Sepsis Systemic Inflammatory Response Syndrome and Sepsis: What Do They Mean?

Abstract

ObjectivesSepsis is one of the most common reasons of increased mortality and morbidity in the intensive care unit. The changes in CRP levels and hemogram parameters and their combinations may help to distinguish sepsis from non-sepsis SIRS. The aim of this study is to investigate the CRP and hemogram parameters as an indicator of sepsis.MethodsA total of 2777 patients admitted to the ICU of two centers between 2006–2013 were evaluated retrospectively. The patients were diagnosed as SIRS (-), non-sepsis SIRS and sepsis. The patients who were under 18 years old, re-admitted, diagnosed with hematological disease, on corticosteroid and immunosuppressive therapy, SIRS (-), culture negative, undocumented laboratory values and outcomes were excluded. 1257 patients were divided into 2 groups as non-sepsis SIRS and sepsis. The patients’ demographic data, CRP levels, hemogram parameters, length of ICU stay and mortality were recorded.Results1257 patients were categorized as non-sepsis SIRS (816, 64.9%) and sepsis (441, 35.1%). In the multivariate analysis, the likelihood of sepsis was increased 3.2 (2.2–4.6), 1.7 (1.2–2.4), 1.6 (1.2–2.1), 2.3 (1.4–3.8), 1.5 (1.1–2.1) times by the APACHE II≥13, SOFA score≥4, CRP≥4.0, LymC<0.45 and PLTC<150 respectively (p<0.001 p = 0.007 p = 0.004 p<0.001 p = 0.027). The likelihood of sepsis was increased 18.1 (8.4–38.7) times by the combination of CRP≥4.0, lymC<0.45 and PLTC<150 (P<0.001).ConclusionsWhile WBCC, NeuC, Neu%, NLCR and EoC are far from being the indicators to distinguish sepsis from non-sepsis SIRS, the combinations of CRP, LymC and PLTC can be used to determine the likelihood of sepsis.

Procalcitonin and C-reactive Protein Perform Better Than Neutrophil-Lymphocyte Count Ratio on Evaluation of Hospital Acquired Pneumonia

“…The results from the present study suggest that APACHE II performed best in discriminating HAP with noninfection status as a single indicator (Figure 2,3). It has been proved to be a valuable marker to predict mortality in septic patients [28].…”

Impact of different consensus definition criteria on sepsis diagnosis in a cohort of critically ill patients—Insights from a new mathematical probabilistic approach to mortality-based validation of sepsis criteria

“…By the time a patient develops signs of an organ dysfunction or systemic inflammation it is often unclear whether these conditions are related to an infection or not [2,[14][15][16]. An infection-specific occurrence would therefore be essential for a reliable sepsis criterion [51].…”

“…In clinical practice not only the differentiation between 'uncomplicated infection' and sepsis is challenging. Additionally, by the time a patient develops signs of organ dysfunction or systemic inflammation it is often unclear whether these conditions are related to an infection or not [2,[14][15][16]. Ideal sepsis criteria should therefore not only differentiate between patients with sepsis and with uncomplicated infection, but also help to separate patients who are critically ill due to sepsis from those suffering from non-infectious conditions.…”

Effect of interleukin‑31 on septic shock through regulating inflammasomes and interleukin‑1β

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