Combined quantification of procalcitonin and HLA-DR improves sepsis detection in surgical patients
Abstract Early recognition of sepsis is a key factor to improve survival to this disease in surgical patients, since it allows prompt control of the infectious source. Combining pro-inflammatory and immunosupression biomarkers could represent a good strategy to improve sepsis detection. Here we eval...
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Nature Portfolio
2018
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oai:doaj.org-article:0f0f9c8235c64cf4847e654bdf8c87db2021-12-02T15:08:29ZCombined quantification of procalcitonin and HLA-DR improves sepsis detection in surgical patients10.1038/s41598-018-30505-72045-2322https://doaj.org/article/0f0f9c8235c64cf4847e654bdf8c87db2018-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-30505-7https://doaj.org/toc/2045-2322Abstract Early recognition of sepsis is a key factor to improve survival to this disease in surgical patients, since it allows prompt control of the infectious source. Combining pro-inflammatory and immunosupression biomarkers could represent a good strategy to improve sepsis detection. Here we evaluated the combination of procalcitonin (PCT) with gene expression levels of HLA-DRA to detect sepsis in a cohort of 154 surgical patients (101 with sepsis and 53 with no infection). HLA-DRA expression was quantified using droplet digital PCR, a next-generation PCR technology. Area under the receiver operating curve analysis (AUROC) showed that the PCT/HLA-DRA ratio outperformed PCT to detect sepsis (AUROC [CI95%], p): PCT: 0.80 [0.73–0.88], <0.001; PCT/HLA-DRA: 0.85 [0.78–0.91], <0.001. In the multivariate analysis, the ratio showed a superior ability to predict sepsis compared to that of PCT (OR [CI 95%], p): PCT/HLA-DRA: 7.66 [1.82–32.29], 0.006; PCT: 4.21 [1.15–15.43] 0.030. Multivariate analysis was confirmed using a new surgical cohort with 74 sepsis patients and 21 controls: PCT/HLA-DRA: 34.86 [1.22–995.08], 0.038; PCT: 5.52 [0.40–75.78], 0.201. In conclusion, the combination of PCT with HLA-DRA is a promising strategy for improving sepsis detection in surgical patients.Raquel AlmansaSilvia MartínMarta Martin-FernandezMaría Heredia-RodríguezEsther Gómez-SánchezMarta AragónCristina AndrésDolores CalvoJesus Rico-FeijooMaria Carmen Esteban-VelascoLuis Mario Vaquero-RonceroAlicia OrtegaEstefania Gómez-PesqueraMario Lorenzo-LópezIñigo López de CenarruzabeitiaDiana BenavidesJaime López-SanchezCristina DoncelCarmen González-SanchezEsther ZarcaAlberto Ríos-LlorenteAgustín DiazElisa Sanchez-BarradoJuan Beltran de HerediaJose Maria Calvo-VecinoLuis Muñoz-BellvísJose Ignacio Gomez-HerrerasCésar AldecoaEduardo TamayoJesus F. Bermejo-MartinNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-9 (2018) |
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Medicine R Science Q Raquel Almansa Silvia Martín Marta Martin-Fernandez María Heredia-Rodríguez Esther Gómez-Sánchez Marta Aragón Cristina Andrés Dolores Calvo Jesus Rico-Feijoo Maria Carmen Esteban-Velasco Luis Mario Vaquero-Roncero Alicia Ortega Estefania Gómez-Pesquera Mario Lorenzo-López Iñigo López de Cenarruzabeitia Diana Benavides Jaime López-Sanchez Cristina Doncel Carmen González-Sanchez Esther Zarca Alberto Ríos-Llorente Agustín Diaz Elisa Sanchez-Barrado Juan Beltran de Heredia Jose Maria Calvo-Vecino Luis Muñoz-Bellvís Jose Ignacio Gomez-Herreras César Aldecoa Eduardo Tamayo Jesus F. Bermejo-Martin Combined quantification of procalcitonin and HLA-DR improves sepsis detection in surgical patients |
| description |
Abstract Early recognition of sepsis is a key factor to improve survival to this disease in surgical patients, since it allows prompt control of the infectious source. Combining pro-inflammatory and immunosupression biomarkers could represent a good strategy to improve sepsis detection. Here we evaluated the combination of procalcitonin (PCT) with gene expression levels of HLA-DRA to detect sepsis in a cohort of 154 surgical patients (101 with sepsis and 53 with no infection). HLA-DRA expression was quantified using droplet digital PCR, a next-generation PCR technology. Area under the receiver operating curve analysis (AUROC) showed that the PCT/HLA-DRA ratio outperformed PCT to detect sepsis (AUROC [CI95%], p): PCT: 0.80 [0.73–0.88], <0.001; PCT/HLA-DRA: 0.85 [0.78–0.91], <0.001. In the multivariate analysis, the ratio showed a superior ability to predict sepsis compared to that of PCT (OR [CI 95%], p): PCT/HLA-DRA: 7.66 [1.82–32.29], 0.006; PCT: 4.21 [1.15–15.43] 0.030. Multivariate analysis was confirmed using a new surgical cohort with 74 sepsis patients and 21 controls: PCT/HLA-DRA: 34.86 [1.22–995.08], 0.038; PCT: 5.52 [0.40–75.78], 0.201. In conclusion, the combination of PCT with HLA-DRA is a promising strategy for improving sepsis detection in surgical patients. |
| format |
article |
| author |
Raquel Almansa Silvia Martín Marta Martin-Fernandez María Heredia-Rodríguez Esther Gómez-Sánchez Marta Aragón Cristina Andrés Dolores Calvo Jesus Rico-Feijoo Maria Carmen Esteban-Velasco Luis Mario Vaquero-Roncero Alicia Ortega Estefania Gómez-Pesquera Mario Lorenzo-López Iñigo López de Cenarruzabeitia Diana Benavides Jaime López-Sanchez Cristina Doncel Carmen González-Sanchez Esther Zarca Alberto Ríos-Llorente Agustín Diaz Elisa Sanchez-Barrado Juan Beltran de Heredia Jose Maria Calvo-Vecino Luis Muñoz-Bellvís Jose Ignacio Gomez-Herreras César Aldecoa Eduardo Tamayo Jesus F. Bermejo-Martin |
| author_facet |
Raquel Almansa Silvia Martín Marta Martin-Fernandez María Heredia-Rodríguez Esther Gómez-Sánchez Marta Aragón Cristina Andrés Dolores Calvo Jesus Rico-Feijoo Maria Carmen Esteban-Velasco Luis Mario Vaquero-Roncero Alicia Ortega Estefania Gómez-Pesquera Mario Lorenzo-López Iñigo López de Cenarruzabeitia Diana Benavides Jaime López-Sanchez Cristina Doncel Carmen González-Sanchez Esther Zarca Alberto Ríos-Llorente Agustín Diaz Elisa Sanchez-Barrado Juan Beltran de Heredia Jose Maria Calvo-Vecino Luis Muñoz-Bellvís Jose Ignacio Gomez-Herreras César Aldecoa Eduardo Tamayo Jesus F. Bermejo-Martin |
| author_sort |
Raquel Almansa |
| title |
Combined quantification of procalcitonin and HLA-DR improves sepsis detection in surgical patients |
| title_short |
Combined quantification of procalcitonin and HLA-DR improves sepsis detection in surgical patients |
| title_full |
Combined quantification of procalcitonin and HLA-DR improves sepsis detection in surgical patients |
| title_fullStr |
Combined quantification of procalcitonin and HLA-DR improves sepsis detection in surgical patients |
| title_full_unstemmed |
Combined quantification of procalcitonin and HLA-DR improves sepsis detection in surgical patients |
| title_sort |
combined quantification of procalcitonin and hla-dr improves sepsis detection in surgical patients |
| publisher |
Nature Portfolio |
| publishDate |
2018 |
| url |
https://doaj.org/article/0f0f9c8235c64cf4847e654bdf8c87db |
| work_keys_str_mv |
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