Affiliation:
1. Clinical Pathology and Microbiology Laboratory, University Hospital Campus Bio-Medico of Rome, 00128 Rome, Italy
2. Department of Infectious, Parasitic, and Immune-Mediated Diseases, Epidemiology Unit, Reference Centre on Phylogeny, Molecular Epidemiology, and Microbial Evolution (FEMEM), National Institute of Health, 00161 Rome, Italy
Abstract
Background. Elevated cytokines levels correlate with sepsis severity and mortality but their role in the diagnosis is controversial, whereas Procalcitonin (PCT) has been largely used. Recently, the mid-regional proadrenomedullin (MR-proADM) has been combined with PCT for diagnosis optimization. In this study the combined measurement of PCT, MR-proADM, and cytokines in patients with sepsis was evaluated.Methods. One hundred and four septic patients and 101 controls were enrolled. Receiver operating characteristic (ROC) analysis and multiple logistic regression were used to evaluate applicant markers for sepsis diagnosis. Markers with best Odds Ratio (OR) were combined, and the posttest probability and a composite score were computed.Results. Based upon ROC curves analysis, PCT, MR-proADM, IL-6, IL-10, TNF-α, and MCP-1 were considered applicant for sepsis diagnosis. Among these PCT, MR-proADM , IL-6, and TNF-αshowed the best OR. A better posttest probability was found with the combination of PCT with MR-proADM and PCT with IL-6 or TNF-αcompared to the single marker. A composite score of PCT, MR-proADM, and TNF-αshowed the best ROC curve in the early diagnosis of sepsis.Conclusion. The combination of PCT with other markers should expedite diagnosis and treatment of sepsis optimizing clinical management.
Subject
Biochemistry (medical),Clinical Biochemistry,Genetics,Molecular Biology,General Medicine
Cited by
41 articles.
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