C-reactive protein and procalcitonin during course of sepsis and septic shock

Schupp, Tobias; Weidner, Kathrin; Rusnak, Jonas; Jawhar, Schanas; Forner, Jan; Dulatahu, Floriana; Dudda, Jonas; Brück, Lea Marie; Hoffmann, Ursula; Bertsch, Thomas; Akın, İbrahim; Behnes, Michael

doi:10.1007/s11845-023-03385-8

Cited by 12 publications

(3 citation statements)

References 31 publications

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“…C-reactive protein (CRP) is an inflammatory marker that has limited value in predicting 30-day ICU mortality. 41 The predictive indicators mentioned in previous studies largely overlap with those in our study. By employing LASSO regression, our study identified simple clinical and laboratory indicators for predicting ICU mortality in sepsis and achieved a higher prediction AUC, underscoring the significance of these ten indicators.…”

Section: Discussionsupporting

confidence: 79%

LASSO-Based Identification of Risk Factors and Development of a Prediction Model for Sepsis Patients

Hong,

Xiong,

Xia

et al. 2024

TCRM

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Objective The objective of this study was to utilize LASSO regression (Least Absolute Shrinkage and Selection Operator Regression) to identify key variables in septic patients and develop a predictive model for intensive care unit (ICU) mortality. Methods We conducted a cohort consisting of septic patients admitted to the ICU between December 2016 and July 2019. The disease severity and laboratory index were analyzed using LASSO regression. The selected variables were then used to develop a model for predicting ICU mortality. AUCs of ROCs were applied to assess the prediction model, and the accuracy, sensitivity and specificity were calculated. Calibration were also used to assess the actual and predicted values of the predictive model. Results A total of 1733 septic patients were included, among of whom 382 (22%) died during ICU stay. Ten variables, namely mechanical ventilation (MV) requirement, hemofiltration (HF) requirement, norepinephrine (NE) requirement, septicemia, multiple drug-resistance infection (MDR), thrombocytopenia, hematocrit, red-cell deviation width coefficient of variation (RDW-CV), C-reactive protein (CRP), and antithrombin (AT) III, showed the strongest association with sepsis-related mortality according to LASSO regression. When these variables were combined into a predictive model, the area under the curve (AUC) was found to be 0.801. The AUC of the validation group was 0.791. The specificity of the model was as high as 0.953. Within the probability range of 0.25 to 0.90, the predictive performance of the model surpassed that of individual predictors within the cohort. Conclusion Our findings suggest that a predictive model incorporating the variables of MV requirement, HF requirement, NE requirement, septicemia, MDR, thrombocytopenia, HCT, RDW-CV, CRP, and AT III exhibiting an 80% likelihood of predicting ICU mortality in sepsis and demonstrates high accuracy.

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Section: Discussionsupporting

confidence: 79%

LASSO-Based Identification of Risk Factors and Development of a Prediction Model for Sepsis Patients

Hong,

Xiong,

Xia

et al. 2024

TCRM

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“…Contrary to our results, the study of Schupp et al that investigates the diagnostic and prognostic value of C-reactive protein and procalcitonin in patients with sepsis and septic shock shows that CRP and procalcitonin have a poor predictive value about 30-day all-cause mortality. 29 Therefore, the present study highlights the need to further evaluate inflammatory biomarkers in patients with pulmonary septic shock and severe ARDS.…”

Section: Discussionmentioning

confidence: 90%

COVID-19 Related Acute Respiratory Distress Syndrome versus Classical Acute Respiratory Distress Syndrome Patients: Inflammatory Biomarkers as Predictors of Mortality in Pulmonary Septic Shock

Trebuian,

Popa,

Buleu

et al. 2024

IJGM

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Introduction and Objectives Coronavirus disease-2019 (COVID-19)-related severe acute respiratory distress syndrome (ARDS) differs pathophysiological from other pulmonary septic shock-related ARDS. Thus, we assessed whether all-cause in-hospital mortality differs for severe COVID-19-related and classical severe ARDS and which inflammatory biomarkers can predict mortality among these patients. Material and Methods This single-center, retrospective, observational cohort study included pulmonary septic shock patients (n = 114) with COVID-19-related and classical severe ARDS admitted in the Intensive Care Unit. Results Patients with a mean age of 73 (IQR 62–82), predominantly male (63%), were divided into two groups based on outcomes: survivors (n = 50) and non-survivors (n = 64). COVID-19-related severe ARDS (n = 48) accounts for 75% of deaths. Present comorbidities like heart disease (p = 0.043), neurologic disorders (p = 0.018), and liver disease (p = 0.038) were associated with in-hospital mortality, as well. Regarding inflammatory biomarkers, the AUC/ c -statistic was 0.656 (95% CI: 0.53–0.759) for leukocytes, 0.613 (95% CI: 0.509–0.717) C-reactive protein (CRP) and 0.651 (95% CI: 0.548–0.753) for procalcitonin in predicting all-cause in-hospital mortality among patients with pulmonary septic shock and severe ARDS. Conclusion Patients with pulmonary septic shock and with COVID-19-related severe ARDS had a higher incidence of in-hospital mortality than those with classical severe ARDS. The high value of leukocytes, C-reactive protein, and procalcitonin were predictive for all-cause in-hospital mortality in patients with pulmonary septic shock and ARDS. Infection with COVID-19 was an independent predictor of in-hospital mortality in the presence of ARDS.

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“…Sepsis is a common lethal condition that affects patients in the intensive care unit, and is associated with a high risk of mortality ( 1 , 2 ). The sepsis-induced inflammatory response leads to significant damage to the intestines and subsequent bacterial translocation, thereby causing the development of systemic infections and eventually resulting in death ( 3 – 5 ).…”

Section: Introductionmentioning

confidence: 99%

L-valine derived from the gut microbiota protects sepsis-induced intestinal injury and negatively correlates with the severity of sepsis

Chen,

Sun,

et al. 2024

Front. Immunol.

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BackgroundThe protective role of gut microbiota and its metabolites against intestinal damage in sepsis patients remain unclear.MethodsFecal samples were acquired from patients categorized into sepsis and non-sepsis groups for analysis of microbial composition via 16S rRNA sequencing and untargeted metabolomics analysis. We assessed the impact of gut microbiota from sepsis patients on intestinal barriers in antibiotic-treated mice. Furthermore, We conducted spearman’s correlation analysis to examine the relationship between metabolites and the severity of sepsis. Additionally, we performed animal experiments to validate the functionality of identified metabolites.ResultsThe diversity of intestinal flora is decreased in patients with sepsis compared to the control group. Through fecal microbiota transplantation experiments, it was discovered that the gut microbiota derived from sepsis patients could induce intestinal damage in antibiotic-treated mice. Metabolomics analysis of the microbiota revealed a significant enrichment of the Valine, leucine, and isoleucine biosynthesis pathway. Further analysis showed a significant decrease in the abundance of L-valine in sepsis patients, which was negatively correlated with APACHE-II and SOFA scores. In sepsis mouse experiments, it was found that L-valine could alleviate sepsis-induced intestinal damage.ConclusionAlterations in microbial and metabolic features in the gut can affect the severity of sepsis. Furthermore, L-valine can protect against sepsis-induced intestinal injury.

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C-reactive protein and procalcitonin during course of sepsis and septic shock

Cited by 12 publications

References 31 publications

LASSO-Based Identification of Risk Factors and Development of a Prediction Model for Sepsis Patients

LASSO-Based Identification of Risk Factors and Development of a Prediction Model for Sepsis Patients

COVID-19 Related Acute Respiratory Distress Syndrome versus Classical Acute Respiratory Distress Syndrome Patients: Inflammatory Biomarkers as Predictors of Mortality in Pulmonary Septic Shock

L-valine derived from the gut microbiota protects sepsis-induced intestinal injury and negatively correlates with the severity of sepsis

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