TY - JOUR
T1 - Diagnostic accuracy and clinical relevance of an inflammatory biomarker panel for sepsis in adult critically ill patients
AU - Bauer, Philippe R.
AU - Kashyap, Rahul
AU - League, Stacy C.
AU - Park, John G.
AU - Block, Darci R.
AU - Baumann, Nikola A.
AU - Algeciras-Schimnich, Alicia
AU - Jenkins, Sarah M.
AU - Smith, Carin Y.
AU - Gajic, Ognjen
AU - Abraham, Roshini S.
N1 - Funding Information:
Funding: This work was made possible in part by the Center for Clinical and Translational Science (CCaTS) Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This work was funded by a small grant from the Critical Care Committee, Mayo Clinic, Rochester, MN.
Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - The objective of this study was to assess the diagnostic accuracy of C-reactive protein (CRP), procalcitonin (PCT), and cellular immune markers levels in sepsis. This was a prospective observational study in adult intensive care unit (ICU) patients, between 2012 and 2014. The 8-color flow cytometric biomarker panel included CD64, CD163, and HLA-DR. Index test results were compared with sepsis, using receiver operating characteristic curve analyses. Multivariate logistic regression assessed the relationship of sets of markers with the probability of sepsis. Of 219 enrolled patients, 120 had sepsis. C-statistic was the highest for CRP (0.86) followed by neutrophil CD64 expression (0.83), procalcitonin (0.82), and Acute Physiology and Chronic Health Evaluation (APACHE) IV (0.72). After adjustment for APACHE IV, the combination of CRP, PCT, and neutrophil CD64 measure remained a significant predictor of sepsis with an excellent AUC (0.90). In a targeted ICU population at increased risk of sepsis, CRP, PCT, and neutrophil CD64 combined improve the diagnostic accuracy of sepsis.
AB - The objective of this study was to assess the diagnostic accuracy of C-reactive protein (CRP), procalcitonin (PCT), and cellular immune markers levels in sepsis. This was a prospective observational study in adult intensive care unit (ICU) patients, between 2012 and 2014. The 8-color flow cytometric biomarker panel included CD64, CD163, and HLA-DR. Index test results were compared with sepsis, using receiver operating characteristic curve analyses. Multivariate logistic regression assessed the relationship of sets of markers with the probability of sepsis. Of 219 enrolled patients, 120 had sepsis. C-statistic was the highest for CRP (0.86) followed by neutrophil CD64 expression (0.83), procalcitonin (0.82), and Acute Physiology and Chronic Health Evaluation (APACHE) IV (0.72). After adjustment for APACHE IV, the combination of CRP, PCT, and neutrophil CD64 measure remained a significant predictor of sepsis with an excellent AUC (0.90). In a targeted ICU population at increased risk of sepsis, CRP, PCT, and neutrophil CD64 combined improve the diagnostic accuracy of sepsis.
KW - C-reactive protein
KW - CD64
KW - Procalcitonin
KW - Sensitivity and specificity
KW - Sepsis
KW - Study of diagnostic accuracy
UR - http://www.scopus.com/inward/record.url?scp=84954392490&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84954392490&partnerID=8YFLogxK
U2 - 10.1016/j.diagmicrobio.2015.10.003
DO - 10.1016/j.diagmicrobio.2015.10.003
M3 - Article
C2 - 26586579
AN - SCOPUS:84954392490
SN - 0732-8893
VL - 84
SP - 175
EP - 180
JO - Diagnostic Microbiology and Infectious Disease
JF - Diagnostic Microbiology and Infectious Disease
IS - 2
ER -