The value of sepsis biomarkers and their kinetics in the prognosis of septic shock due to bacterial infections

Bahloul, Mabrouk; Bradii, Sabrine; Turki, Mouna; Bouchaala, Karama; Hamida, Chokri Ben; Chelly, Hédi; Ayedi, Fatma; Bouaziz, Mounir

doi:10.5114/ait.2021.108624

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…The kinetics of CRP and PCT levels during the course of septic shock were investigated within a study by Bahloul et al including 60 patients, demonstrating a fall in CRP or PCT level was associated with improved prognosis [ 25 ]. On the other hand, CRP and PCT were inferior to interleukin-6 (IL-6) predicting treatment success in 328 patients with sepsis when re-assessed after 48–72 h [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2023

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Objective The study investigates the diagnostic and prognostic value of C-reactive protein (CRP) and procalcitonin (PCT) in patients with sepsis and septic shock. Background Limited data regarding the prognostic value of CRP and PCT during the course of sepsis or septic shock is available. Methods Consecutive patients with sepsis and septic shock from 2019 to 2021 were included monocentrically. Blood samples were retrieved from the day of disease onset (day 1), day 2, 3, 5, 7, and 10. Firstly, the diagnostic value of CRP and PCT for the diagnosis of a septic shock, as well as for the discrimination of positive blood cultures, was tested. Secondly, the prognostic value of the CRP and PCT was tested for 30-day all-cause mortality. Statistical analyses included univariable t-tests, Spearman’s correlations, C-statistics, and Kaplan–Meier analyses. Results A total of 349 patients were included, of which 56% had a sepsis and 44% a septic shock on day 1. The overall rate of all-cause mortality at 30 days was 52%. With an area under the curve (AUC) of 0.861 on day 7 and 0.833 on day 10, the PCT revealed a superior AUC than the CRP (AUC 0.440–0.652) with regard to the discrimination between patients with sepsis and septic shock. In contrast, the prognostic AUCs for 30-day all-cause mortality were poor. Both higher CRP (HR = 0.999; 95% CI 0.998–1.001; p = 0.203) and PCT levels (HR = 0.998; 95% CI 0.993–1.003; p = 0.500) were not associated with the risk of 30-day all-cause mortality. During the first 10 days of ICU treatment, both CRP and PCT declined irrespective of clinical improvement or impairment. Conclusion PCT was a reliable diagnostic tool for the diagnosis of septic shock compared to CRP. Both CRP and PCT were shown to have poor predictive value with regard to 30-day all-cause mortality and were not associated with the risk of all-cause mortality in patients admitted with sepsis or septic shock.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2023

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“…Of note, kinetics were different among survivors and non-survivors. CRP levels in survivors decreased after day 1 and remained high in non-survivors after an increase up to day 3 [38]. In line with this, Miki et al showed that CRP levels and peaks in patients admitted with sepsis depended on the individuals' outcomes.…”

Section: Discussionmentioning

confidence: 79%

C-Reactive Protein and White Blood Cell Count in Cardiogenic Shock

Dudda

Schupp

Rusnak

et al. 2023

JCM

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This study examines the prognostic impact of C-reactive protein (CRP) and white blood cell (WBC) counts in patients with cardiogenic shock (CS). Data regarding the prognostic impact of inflammatory biomarkers in CS are scarce. All consecutive patients with CS from 2019 to 2021 admitted to a cardiac intensive care unit (ICU) were included at one institution. Laboratory measurements were retrieved from the day of admission (i.e., day 1), as well as days 2, 3, 4, and 8. The primary endpoint was 30-day all-cause mortality. Statistical analyses included univariate t-tests, Spearman’s correlations, C-statistics, Kaplan–Meier, and Cox regression analyses. From a total of 240 consecutive patients admitted with CS, 55% died within 30 days. CRP levels on days 3 to 8 were associated with reliable discrimination for 30-day all-cause mortality (area under the curve (AUC): 0.623–0.754), whereas CRP on day 1 was not (AUC = 0.514). In line, CRP > 100 mg/L on day 3 (56% vs. 37%; log-rank p = 0.023; HR = 1.702; 95% CI 1.060–2.735; p = 0.028) and especially a CRP increase of at least 200% from days 1 to day 3 (51% vs. 35%; log-rank p = 0.040; HR = 1.720; 95% CI 1.006–2.943; p = 0.048) were associated with an increased risk of all-cause mortality. Furthermore, WBC on day 1 discriminated 30-day all-cause mortality (AUC = 0.605; p = 0.005) with an increased risk of all-cause mortality in patients admitted with WBC > 10 × 106/mL (59% vs. 40%; log-rank p = 0.036; HR = 1.643; 95% CI 1.010–2.671; p = 0.045). In conclusion, WBC count on admission as well as CRP levels during the course of ICU treatment were associated with 30-day all-cause mortality. Specifically, an increase of CRP levels by at least 200% from day 1 to day 3 during the course of ICU treatment was associated with an increased risk of 30-day all-cause mortality. The present study is one of the first to describe the prognostic value of inflammatory biomarkers in consecutive all-comer CS patients treated at a cardiac ICU.

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C-reactive Protein Variation and Its Usefulness in the Prognostication and Monitoring of Patients With Pneumococcal Pneumonia

Gomes,

Ribeiro,

Froes

et al. 2024

Cureus

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Background and objective Community-acquired pneumonia (CAP) is a prevalent and life-threatening infection that causes significant morbidity and mortality. Biomarkers, such as C-reactive protein (CRP), can help to diagnose, monitor, and prognose patients with this condition. This study aimed to analyze the disease course, the CRP peak concentration, its relationship with prognosis, and its variation in hospitalized patients with pneumococcal CAP. Methodology This study included 797 patients diagnosed with pneumococcal CAP and admitted over four years to four different Portuguese hospitals, either to the ICU or the general ward. Results Although CRP peak concentration was not a good predictor of overall hospital mortality, higher peak concentration in older patients (>60 years) was associated with a dismal hospital prognosis. In contrast, younger patients who survived hospital discharge had a non-significant higher peak CRP concentration. A faster time until CRP decreased to at least half of its peak value also correlated with favorable outcomes after adjusting for age and bacteremia [failure to achieve a 50% decrease was associated with an adjusted hazard ratio (HR) for hospital mortality of 6.45; 95% confidence interval (CI): 4.30-9.69]. Conclusions Based on our findings, CRP may be a useful biomarker in the hospital setting for diagnosing and monitoring patients with pneumococcal CAP. Clinicians must be aware of its unique properties, clinical applications, and varying behaviors according to patient age groups.

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The value of sepsis biomarkers and their kinetics in the prognosis of septic shock due to bacterial infections

Cited by 3 publications

References 20 publications

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

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

C-Reactive Protein and White Blood Cell Count in Cardiogenic Shock

C-reactive Protein Variation and Its Usefulness in the Prognostication and Monitoring of Patients With Pneumococcal Pneumonia

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