Relation between inflammatory markers and sepsis in critically ill patients

Amir Hafez, Amani K. Mohamed, D. Zakaria, Asmaa S Hassan
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引用次数: 1

Abstract

Background Sepsis and septic shock is a serious complication in ICU patients. Early identification can help to improve the outcome. C-reactive protein (CRP) and neutrophil–lymphocyte ratio (NLR) are suggested markers for diagnosis. The aim of the work is to evaluate the relation between inflammatory markers and sepsis in critically ill patients. Patients and methods The study included 30 patients with different degrees of sepsis and septic shock in addition to age-matched and sex-matched healthy controls. All patients were subjected to full clinical examination. The clinical condition of the patients was further assessed using acute physiology age chronic health evaluation II score and Sequential (sepsis-related) Organ Failure Assessment score. The performed laboratory investigations included complete blood count, coagulation profile, erythrocyte sedimentation rate, CRP, renal function tests (blood urea, serum creatinine, sodium, and potassium), liver function tests (serum albumin and bilirubin), and pan-cultures. Results Among the studied patients, there were 16 (53.3%) patients with sepsis, seven (23.3%) patients with severe sepsis, and seven (23.3%) patients with septic shock. Six (20.0%) patients died at the end of the study. The patients had a significantly higher CRP (46.6±24.3 vs. 6.7±3.3 mg/dl, P<0.001) and NLR (21.6±2.8 vs. 2.8±1.9, P<0.004) levels when compared with controls. Comparison between patients with different degrees of sepsis showed a significant increase of CRP and NLR with increasing the severity of sepsis. There was a significant positive correlation between CRP and NLR and both acute physiology age chronic health evaluation II and Sequential (sepsis-related) Organ Failure Assessment scores. Receiver-operating characteristic curve analysis showed good performance of CRP (cutoff: 40, sensitivity: 80%, and specificity: 84%) and NLR (cutoff: 8.75, sensitivity: 86.7, and specificity: 90.0) for the diagnosis of sepsis. Conclusions Use of CRP and NLR as early predictors of sepsis and septic shock development is reliable and convenient.
危重症患者炎症标志物与脓毒症的关系
脓毒症和感染性休克是ICU患者的严重并发症。早期识别有助于改善结果。c反应蛋白(CRP)和中性粒细胞淋巴细胞比值(NLR)是建议的诊断指标。这项工作的目的是评估炎症标志物与危重患者脓毒症之间的关系。患者和方法本研究包括30例不同程度脓毒症和脓毒性休克患者,以及年龄和性别匹配的健康对照。所有患者均接受了全面的临床检查。采用急性生理、年龄、慢性健康评估II评分和顺序(败血症相关)器官衰竭评估评分进一步评估患者的临床状况。进行的实验室检查包括全血细胞计数、凝血谱、红细胞沉降率、CRP、肾功能检查(尿素、血清肌酐、钠和钾)、肝功能检查(血清白蛋白和胆红素)和泛培养。结果本组患者中,脓毒症16例(53.3%),严重脓毒症7例(23.3%),感染性休克7例(23.3%)。6例(20.0%)患者在研究结束时死亡。与对照组相比,患者CRP(46.6±24.3 vs. 6.7±3.3 mg/dl, P<0.001)和NLR(21.6±2.8 vs. 2.8±1.9,P<0.004)水平显著升高。不同程度脓毒症患者的比较显示,随着脓毒症严重程度的增加,CRP和NLR明显升高。CRP和NLR与急性生理年龄、慢性健康评估II和序次(败血症相关)器官衰竭评估评分均有显著正相关。患者工作特征曲线分析显示,CRP(临界值:40,敏感性:80%,特异性:84%)和NLR(临界值:8.75,敏感性:86.7,特异性:90.0)对脓毒症的诊断有较好的效果。结论使用CRP和NLR作为脓毒症和感染性休克发展的早期预测指标可靠且方便。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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