The Role of Biomarkers and Scores in Describing Urosepsis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients Selection
- Fever, temperature above 38 °C, or hypothermia below 36 °C.
- Tachycardia—over 90/min.
- Tachypnea—over 20 breaths/min or partial pressure of carbon dioxide in the arterial blood (PaCO2) < 32 mm Hg.
- Leukocytosis > 12,000/mm3 or leukopenia < 4000/mm3, or the presence of immature cells in the periphery < 10% [8].
2.2. Collected Factors
2.3. Vadiable Definition
2.4. Patient Grouping According to the Disease Stage
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Deceased | SIRS | Sepsis | Septic Shock | |||||
---|---|---|---|---|---|---|---|---|
Yes | No | Yes | No | Yes | No | Yes | No | |
No | 23 | 151 | 46 | 128 | 88 | 86 | 40 | 134 |
Age (years) Mean ± SD | 71.04 ± 11.03 | 59.91 ± 16.04 | 56.84 ± 17.22 | 62.97 ± 15.17 | 60.37 ± 15.54 | 62.40 ± 16.29 | 69.03 ± 12.72 | 59.10 ± 16.08 |
p value ** | <0.001 | <0.01 | 0.40 | <0.0001 | ||||
leukocyte (106/L) median (IQR) | 18,270.0 (12,582.5–24,550.0) | 16,360.0 (11,615.0–20,625.0) | 16,065.0 (12,050.0–19,310.0) | 16,470.0 (11,635.0–21,705.0) | 16,360.0 (11,367.5–19,937.5) | 16,530.0 (12,082.5–22,337.5) | 18,920.0 (12,395.0–28,140.0) | 16,315.0 (11,600.0–19,660.0) |
p value * | 0.24 | 0.79 | 0.16 | <0.01 | ||||
Procalcitonin (ng/mL) | 32.0 (10.38–32.0) | 7.55 (2.70–12.2) | 2.45 (0.70–3.20) | 11.20 (7.25–22.32) | 9.6 (6.3–12.2) | 4.7 (1.7–22.1) | 24.7 (13.5–32.0) | 6.3 (2.70–10.6) |
p value * | <0.0001 | <0.0001 | <0.01 | <0.0001 | ||||
SOFA | 10.0 (8.25–12.0) | 5.0 (3.0–7.0) | 3.0 (2.0–4.0) | 7.0 (5.0–9.0) | 6.0 (4.0–7.0) | 5.0 (3.0–9.0) | 9.5 (8.0–12.0) | 4.5 (3.0–6.0) |
p value * | <0.0001 | <0.0001 | 0.78 | <0.0001 | ||||
qSOFA | 3.0 (2.0–3.0) | 1.0 (0.0–2.0) | 0.0 (0.0–0.0) | 1.0 (1.0–2.0) | 1.0 (0.0–1.75) | 1.0 (0.0–2.0) | 2.0 (2.0–3.0) | 0.0 (0.0–1.0) |
p value * | <0.0001 | <0.0001 | 0.32 | <0.0001 | ||||
CCI | 11.0 (9.2–13.0) | 6.0 (2.0–8.0) | 4.0 (1.0–8.0) | 8.0 (4.0–9.5) | 7.0 (3.0–9.0) | 7.0 (3/25–9/0) | 9.0 (7.0–12.0) | 6.0 (2.0–8.0) |
p value * | <0.0001 | <0.0001 | 0.46 | <0.0001 | ||||
Intensive care days | 5.0 (2.0–8.75) | 0.0 (0.0–1.0) | 0.0 (0.0–0.0) | 1.0 (0.0–3.0) | 0.0 (0.0–1.0) | 1.0 (0.0–3.0) | 3.5 (2.0–7.0) | 0.0 (0.0–1.0) |
p value * | <0.0001 | <0.0001 | <0.001 | <0.0001 | ||||
Hospitalization days | 10.0 (6.25–18.7) | 8.0 (5.0–13.0) | 5.0 (3.0–8.0) | 10.0 (6.5–17.0) | 9.0 (6.0–13.7) | 7.0 (4.0–13.7) | 15.0 (8.0–22.5) | 8.0 (5.0–11.0) |
p value * | 0.22 | <0.0001 | 0.12 | <0.0001 | ||||
Hospitalization costs (Lei) | 10855.0 (6752.5–24,053.2) | 5329.0 (2230.2–9690.5) | 2863.0 (1247.0–6833.0) | 7309.0 (3416.5–14,994.0) | 5836.0 (2351.7–9398.2) | 6833.0 (2663.7–11,805.0) | 14704.5 (7357.0–26,103.5) | 4437.5 (1914.0–7967.0) |
p value * | <0.001 | <0.0001 | 0.40 | <0.0001 |
Deceased | |||||
---|---|---|---|---|---|
Cutoff value | Specificity % (95% CI) | Sensitivity % (95% CI) | AUC % | 95% CI | |
procalcitonin | 12.5 | 69.57 (47.1–86.8) | 77.33 (69.8–83.8) | 77.2 | 70.2 to 83.2 |
leukocytes | 19,340 × 106/L | 47.83 (26.8–69.4) | 70.86 (62.9–78.0) | 57.6 | 49.9 to 65.1 |
CCI | 10 | 65.22 (42.7–83.6) | 88.74 (82.6–93.3) | 86.3 | 80.2 to 91.0 |
SOFA | 7 | 91.33 (72.0–98.9) | 76.82 (69.3–83.3) | 89.3 | 83.7 to 93.5 |
qSOFA | 1 | 91.30 (72.0–98.9) | 74.17 (66.4–80.9) | 90.3 | 84.9 to 94.3 |
SIRS group | |||||
procalcitonin | 4.8 | 91.30 (79.2–97.6) | 85.71 (78.4–91.3) | 93.0 | 88.1 to 96.3 |
leukocytes | 19,750 × 106 L | 80.43 (66.1–90.6) | 32.28 (24.3–41.2) | 51.1 | 43.4 to 58.8 |
CCI | 6 | 67.39 (52.0–80.5) | 61.42 (52.4–69.9) | 70.3 | 62.9 to 77.0 |
SOFA | 4 | 84.78 (71.1–93.7) | 78.74 (70.6–85.5) | 88.3 | 82.5 to 92.7 |
qSOFA | 0 | 84.78 (71.1–93.7) | 76.38 (68.0–83.5) | 83.8 | 77.4 to 88.9 |
Sepsis Group | |||||
procalcitonin | 4.8 | 83.72 (74.2–90.8) | 53.49 (42.4–64.3) | 59.3 | 51.6 to 66.8 |
leucocytes | 24,070 × 106/L | 93.10 (85.6–97.4) | 24.43 (15.8–34.9) | 56.8 | 49.0 to 64.3 |
CCI | 11 | 94.25 | 15.12 | 53.6 | 45.9 to 61.2 |
SOFA | 8 | 91.95 (84.1–96.7) | 32.58 (22.8–43.5) | 51.4 | 43.7 to 59.1 |
qSOFA | 2 | 98.85 (93.8–100.0) | 20.93 (12.9–31.0) | 54.3 | 46.5 to 61.9 |
Septic Shock group | |||||
procalcitonin | 12.4 | 80.00 (64.4–90.9) | 85.61 (78.4–91.1) | 84.1 | 77.8 to 89.2 |
leukocytes | 24,260 × 106 L | 35.00 (20.6–51.7) | 90.98 (84.8–95.3) | 60.7 | 53.0 to 68.1 |
CCI | 6 | 82.5 (67.2–92.7) | 54.89 (46.0–63.5) | 77.4 | 70.4 to 83.4 |
SOFA | 6 | 97.50 (86.8–99.9) | 77.44 (69.4–84.2) | 93.9 | 89.3 to 97.0 |
qSOFA | 1 | 92.50 (79.6–98.4) | 82.71 (75.2–88.7) | 93.0 | 88.2 to 96.4 |
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Guliciuc, M.; Porav-Hodade, D.; Chibelean, B.-C.; Voidazan, S.T.; Ghirca, V.M.; Maier, A.C.; Marinescu, M.; Firescu, D. The Role of Biomarkers and Scores in Describing Urosepsis. Medicina 2023, 59, 597. https://doi.org/10.3390/medicina59030597
Guliciuc M, Porav-Hodade D, Chibelean B-C, Voidazan ST, Ghirca VM, Maier AC, Marinescu M, Firescu D. The Role of Biomarkers and Scores in Describing Urosepsis. Medicina. 2023; 59(3):597. https://doi.org/10.3390/medicina59030597
Chicago/Turabian StyleGuliciuc, Mădălin, Daniel Porav-Hodade, Bogdan-Calin Chibelean, Septimiu Toader Voidazan, Veronica Maria Ghirca, Adrian Cornel Maier, Monica Marinescu, and Dorel Firescu. 2023. "The Role of Biomarkers and Scores in Describing Urosepsis" Medicina 59, no. 3: 597. https://doi.org/10.3390/medicina59030597