Predictive performance of critical illness scores and procalcitonin in sepsis caused by different gram-stain bacteria

Detalhes bibliográficos
Autor(a) principal: Yan, ShengTao
Data de Publicação: 2021
Outros Autores: Zhang, GuoQiang
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Clinics
Texto Completo: https://www.revistas.usp.br/clinics/article/view/212982
Resumo: OBJECTIVES: To compare the early and late predictive values of several critical illness scores (CISs) and biomarkers in sepsis-3 patients with bloodstream infections (BSIs) and to identify the prognostic value of procalcitonin (PCT) for different gram-stain bacteria infections. METHODS: Patients with at least one positive blood culture within 24h of emergency department admission and with a final diagnosis of sepsis/septic shock were enrolled. CISs were calculated based on the first parameters on the day of admission. The receiver operating characteristics curve was used to analyze the predictive value of CISs and biomarkers for early and late mortality. RESULTS: Of 834 enrolled patients with sepsis-3, death occurred in 214 patients within 28 days and in 273 patients within 60 days. Compared with biomarkers, CISs showed a significantly higher area under the curve (AUC) in the prediction of early and late mortality (p<0.01), especially for patients with GNB infection. The Sequential Organ Failure Assessment score showed a higher AUC for predicting early mortality than the Mortality in Emergency Department Sepsis score (p=0.036). Compared with GNB infections, the AUC values of the PCT for gram-positive bacteria (GPB) infections were higher for predicting early or late mortality; PCT showed higher AUC than high-sensitivity C-reactive protein and white blood cells for predicting early mortality (p<0.05). CONCLUSIONS: CISs were more advantageous in the assessment of early and late prognosis, especially for patients with GNB infections; however, for sepsis with GPB infection, PCT can be used for the prediction of early mortality.
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spelling Predictive performance of critical illness scores and procalcitonin in sepsis caused by different gram-stain bacteriaSepsisShockSepticProcalcitoninPrognosisOBJECTIVES: To compare the early and late predictive values of several critical illness scores (CISs) and biomarkers in sepsis-3 patients with bloodstream infections (BSIs) and to identify the prognostic value of procalcitonin (PCT) for different gram-stain bacteria infections. METHODS: Patients with at least one positive blood culture within 24h of emergency department admission and with a final diagnosis of sepsis/septic shock were enrolled. CISs were calculated based on the first parameters on the day of admission. The receiver operating characteristics curve was used to analyze the predictive value of CISs and biomarkers for early and late mortality. RESULTS: Of 834 enrolled patients with sepsis-3, death occurred in 214 patients within 28 days and in 273 patients within 60 days. Compared with biomarkers, CISs showed a significantly higher area under the curve (AUC) in the prediction of early and late mortality (p<0.01), especially for patients with GNB infection. The Sequential Organ Failure Assessment score showed a higher AUC for predicting early mortality than the Mortality in Emergency Department Sepsis score (p=0.036). Compared with GNB infections, the AUC values of the PCT for gram-positive bacteria (GPB) infections were higher for predicting early or late mortality; PCT showed higher AUC than high-sensitivity C-reactive protein and white blood cells for predicting early mortality (p<0.05). CONCLUSIONS: CISs were more advantageous in the assessment of early and late prognosis, especially for patients with GNB infections; however, for sepsis with GPB infection, PCT can be used for the prediction of early mortality.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2021-06-11info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/21298210.6061/clinics/2021/e2610Clinics; Vol. 76 (2021); e2610Clinics; v. 76 (2021); e2610Clinics; Vol. 76 (2021); e26101980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/212982/195006Copyright (c) 2023 Clinicsinfo:eu-repo/semantics/openAccessYan, ShengTaoZhang, GuoQiang2023-07-06T13:04:06Zoai:revistas.usp.br:article/212982Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2023-07-06T13:04:06Clinics - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Predictive performance of critical illness scores and procalcitonin in sepsis caused by different gram-stain bacteria
title Predictive performance of critical illness scores and procalcitonin in sepsis caused by different gram-stain bacteria
spellingShingle Predictive performance of critical illness scores and procalcitonin in sepsis caused by different gram-stain bacteria
Yan, ShengTao
Sepsis
Shock
Septic
Procalcitonin
Prognosis
title_short Predictive performance of critical illness scores and procalcitonin in sepsis caused by different gram-stain bacteria
title_full Predictive performance of critical illness scores and procalcitonin in sepsis caused by different gram-stain bacteria
title_fullStr Predictive performance of critical illness scores and procalcitonin in sepsis caused by different gram-stain bacteria
title_full_unstemmed Predictive performance of critical illness scores and procalcitonin in sepsis caused by different gram-stain bacteria
title_sort Predictive performance of critical illness scores and procalcitonin in sepsis caused by different gram-stain bacteria
author Yan, ShengTao
author_facet Yan, ShengTao
Zhang, GuoQiang
author_role author
author2 Zhang, GuoQiang
author2_role author
dc.contributor.author.fl_str_mv Yan, ShengTao
Zhang, GuoQiang
dc.subject.por.fl_str_mv Sepsis
Shock
Septic
Procalcitonin
Prognosis
topic Sepsis
Shock
Septic
Procalcitonin
Prognosis
description OBJECTIVES: To compare the early and late predictive values of several critical illness scores (CISs) and biomarkers in sepsis-3 patients with bloodstream infections (BSIs) and to identify the prognostic value of procalcitonin (PCT) for different gram-stain bacteria infections. METHODS: Patients with at least one positive blood culture within 24h of emergency department admission and with a final diagnosis of sepsis/septic shock were enrolled. CISs were calculated based on the first parameters on the day of admission. The receiver operating characteristics curve was used to analyze the predictive value of CISs and biomarkers for early and late mortality. RESULTS: Of 834 enrolled patients with sepsis-3, death occurred in 214 patients within 28 days and in 273 patients within 60 days. Compared with biomarkers, CISs showed a significantly higher area under the curve (AUC) in the prediction of early and late mortality (p<0.01), especially for patients with GNB infection. The Sequential Organ Failure Assessment score showed a higher AUC for predicting early mortality than the Mortality in Emergency Department Sepsis score (p=0.036). Compared with GNB infections, the AUC values of the PCT for gram-positive bacteria (GPB) infections were higher for predicting early or late mortality; PCT showed higher AUC than high-sensitivity C-reactive protein and white blood cells for predicting early mortality (p<0.05). CONCLUSIONS: CISs were more advantageous in the assessment of early and late prognosis, especially for patients with GNB infections; however, for sepsis with GPB infection, PCT can be used for the prediction of early mortality.
publishDate 2021
dc.date.none.fl_str_mv 2021-06-11
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/clinics/article/view/212982
10.6061/clinics/2021/e2610
url https://www.revistas.usp.br/clinics/article/view/212982
identifier_str_mv 10.6061/clinics/2021/e2610
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/clinics/article/view/212982/195006
dc.rights.driver.fl_str_mv Copyright (c) 2023 Clinics
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2023 Clinics
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
dc.source.none.fl_str_mv Clinics; Vol. 76 (2021); e2610
Clinics; v. 76 (2021); e2610
Clinics; Vol. 76 (2021); e2610
1980-5322
1807-5932
reponame:Clinics
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Clinics
collection Clinics
repository.name.fl_str_mv Clinics - Universidade de São Paulo (USP)
repository.mail.fl_str_mv ||clinics@hc.fm.usp.br
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