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Table 1 Summary of diagnostic and prognostic performance of cited biomarkers

From: Year in review 2013: Critical Care – sepsis

Biomarker

Context

Performance

Reference

Diagnostic markers

PSP, sCD25, and HBP within 6 hours of admission

Prospective monocentric; 219 patients admitted to the ICU

Diagnosis of sepsis versus SIRS: PSP (cutoff value 30 ng/ml), Se 90% and Sp 83%; sCD25 (cutoff value 2.5 ng/ml), Se 83% and Sp 83%; HBP (cutoff value 50 ng/ml), Se 78% and Sp 36%

[20]

sCD25, IL-10, and IFNγ on days 1 and 7 of hospital admission

Prospective monocentric; 52 patients with SIRS criteria

Diagnosis of bacteriaemic SIRS (day 1): sCD25 (cutoff value 19.9 ng/ml), Se 83% and Sp 83%; IL-10 (cutoff value 3.05 pg/ml), Se 88% and Sp 75%; IFNγ (cutoff value 9 pg/ml), Se 45% and Sp 70%

[21]

Presepsin at admission

Prospective monocentric; 859 ED patients with SIRS criteria

Presepsin >317 pg/ml: diagnosis of sepsis, Se 71% and Sp 86%

[16]

Presepsin at admission

Prospective bicentric; 186 ED patients with SIRS criteria

Presepsin >600 pg/ml: diagnosis of sepsis, Se 79% and Sp 62%

[17]

Prognostic markers

Red blood cell distribution width at admission and at 72 hours

Prospective monocentric; 329 ED patients, severe sepsis or septic shock

Increased baseline RDW and ΔRDW at 72 hours after admission >0.2%: 28-day mortality, OR =9.97 (95% CI =1.99 to 49.91); hospital length of stay, OR =25.45 (95% CI =14.69 to 36.21

[30]

PCT change at 72 hours from baseline

Retrospective multicentre; 154 ED patients with sepsis

Per 10% PCT increase from baseline: ICU mortality, OR =1.3 (95% CI =1.1 to 1.15); 80% PCT decrease from baseline: ICU mortality, Se 91% and NPV 90%

[22]

sCD25 and IL-10 at days 1 and 7 of hospital admission

Prospective monocentric; 52 patients admitted to the hospital with SIRS

ICU mortality of bacteriaemic patients with SIRS: day 1 sCD25 > 19.9 ng/ml, OR =1.12 (95% CI =1.01 to 1.25); day 1 IL-10 > 3.05 pg/ml, OR =1.86 (95% CI =0.98 to 3.52)

[21]

Presepsin at admission

Prospective monocentric; 859 ED patients with SIRS criteria

Evolution to severe sepsis (cutoff value 449 pg/ml), Se 82% and Sp 72%; evolution to septic shock (cutoff value 550 pg/ml), Se 86% and Sp 64%; 28-day mortality (cutoff value 556 pg/ml), Se 62% and Sp 67%

[16]

Serum MDA at day 1

Prospective multicentre; 328 patients with severe sepsis

MDA >4.11 nmol/l: 30-day mortality, HR =1.05 (95% CI =1.02 to 1.09); 6-month mortality, HR =1.05 (95% CI =1.02 to 1.09)

[36]

372 T/C polymorphism of TIMP-1

Prospective multicentre; 275 patients with severe sepsis

If 372 T/C polymorphism present: 30-day mortality, OR =2.08 (95% CI =1.06 to 4.09)

[37]

Kallistatin at days 1 and 4

Prospective monocentric; 54 ICU patients with severe CAP

Kallistatin >8.3 μg/ml: ICU mortality, OR =0.11 (95% CI =0.01 to 1.06)

[18]

Ang-1/Ang-2 ratio at fever onset

Prospective bicentric; 99 cancer and chemotherapy-induced febrile neutropaenia patients

Ang-1/Ang-2 ratio >5: development of septic shock, RR =5.47 (95% CI =1.93 to 15.53); 28-day mortality, RR =4.20 (95% CI =1.60 to 11.05)

[28]

  1. Ang, angiopoietin; CAP, community-acquired pneumonia; CI, confidence interval; ED, emergency department; HBP, heparin binding protein; HR, hazard ratio; IFNγ, interferon gamma; IL, interleukin; MDA, malondialdehyde; NPV, negative predictive value; OR, odds ratio; PCT, procalcitonin; PSP, pancreatic stone protein; RDW, red blood cell distribution width; RR, relative risk; sCD25, soluble CD25; Se, sensitivity; SIRS, systemic inflammatory response syndrome; Sp, specificity; TIMP-1,tissue inhibitor of matrix metalloproteinase 1.