Diagnostic Potential of Coagulation-Related Biomarkers for Sepsis in the Emergency Department: Protocol for a Pilot Observational Cohort Study

Background:. Between 75% and 80% of patients with sepsis arrive in the hospital through the emergency department. Early diagnosis is important to alter patient prognosis, but currently, there is no reliable biomarker. The innate immune response links inflammation and coagulation. Several coagulation...

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Autores principales:	Jaskirat Arora, MBBS, Jennifer A. Klowak, MD, MSc, FRCPC, Sameer Parpia, MSc, PhD, Marcelo Zapata-Canivilo, MD, Walaa Faidi, MSc, Christopher Skappak, MD, PhD, Rachael Gregoris, BHSc, Colin A. Kretz, BSc, PhD, Dhruva J. Dwivedi, BSc, MSc, PhD, Kerstin de Wit, BSc, MSc, MB ChB, MD, FRCPC, FRCEM, MRCP, Michelle Welsford, BSc, MD, FACEP, CCPE, FRCPC, Alison Fox-Robichaud, MSc, MD, FRCPC, on behalf of the Canadian Critical Care Translational Biology Group, Patricia Liaw, Jamie Hutchison, Jane Batt, Sean Gill, Jean-Francois Cailhier
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/97e9fdeb85504be09052fd1bdf14f6b1
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spelling	oai:doaj.org-article:97e9fdeb85504be09052fd1bdf14f6b12021-11-25T07:54:32ZDiagnostic Potential of Coagulation-Related Biomarkers for Sepsis in the Emergency Department: Protocol for a Pilot Observational Cohort Study2639-802810.1097/CCE.0000000000000414https://doaj.org/article/97e9fdeb85504be09052fd1bdf14f6b12021-04-01T00:00:00Zhttp://journals.lww.com/10.1097/CCE.0000000000000414https://doaj.org/toc/2639-8028Background:. Between 75% and 80% of patients with sepsis arrive in the hospital through the emergency department. Early diagnosis is important to alter patient prognosis, but currently, there is no reliable biomarker. The innate immune response links inflammation and coagulation. Several coagulation -related biomarkers are associated with poor prognosis in the ICU. The role of coagulation biomarkers to aid in early sepsis diagnosis has not previously been investigated. The objective of our study is to determine the individual or combined accuracy of coagulation and inflammation biomarkers with standard biochemical tests to diagnose adult septic patients presenting to the emergency department. Methods:. in the Emergency Department is a prospective, observational cohort study with a target enrolment of 250 suspected septic patients from two Canadian emergency departments. The emergency physicians will enroll patients with suspected sepsis. Blood samples will be collected at two time points (initial presentation and 4 hr following). Patients will be adjudicated into septic, infected, or not infected status in accordance with the Sepsis-3 definitions. Patient demographics, cultures, diagnosis, and biomarkers will be reported using descriptive statistics. Optimal cut off values with sensitivity and specificity for each biomarker will be determined using C-statistics to distinguish between septic and nonseptic patients. Stepwise multiple logistic regression analysis with exclusion of nonsignificant covariates from the final model will be used to establish a panel of biomarkers. Conclusions:. Our protocol describes the processes and methods for a pragmatic observational biomarker study in the emergency department. This study will seek to determine the potential diagnostic importance of early coagulation abnormalities to identify additional tools for sepsis diagnosis.Jaskirat Arora, MBBSJennifer A. Klowak, MD, MSc, FRCPCSameer Parpia, MSc, PhDMarcelo Zapata-Canivilo, MDWalaa Faidi, MScChristopher Skappak, MD, PhDRachael Gregoris, BHScColin A. Kretz, BSc, PhDDhruva J. Dwivedi, BSc, MSc, PhDKerstin de Wit, BSc, MSc, MB ChB, MD, FRCPC, FRCEM, MRCPMichelle Welsford, BSc, MD, FACEP, CCPE, FRCPCAlison Fox-Robichaud, MSc, MD, FRCPCon behalf of the Canadian Critical Care Translational Biology GroupPatricia LiawJamie HutchisonJane BattSean GillJean-Francois CailhierWolters KluwerarticleMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENCritical Care Explorations, Vol 3, Iss 4, p e0414 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Jaskirat Arora, MBBS Jennifer A. Klowak, MD, MSc, FRCPC Sameer Parpia, MSc, PhD Marcelo Zapata-Canivilo, MD Walaa Faidi, MSc Christopher Skappak, MD, PhD Rachael Gregoris, BHSc Colin A. Kretz, BSc, PhD Dhruva J. Dwivedi, BSc, MSc, PhD Kerstin de Wit, BSc, MSc, MB ChB, MD, FRCPC, FRCEM, MRCP Michelle Welsford, BSc, MD, FACEP, CCPE, FRCPC Alison Fox-Robichaud, MSc, MD, FRCPC on behalf of the Canadian Critical Care Translational Biology Group Patricia Liaw Jamie Hutchison Jane Batt Sean Gill Jean-Francois Cailhier Diagnostic Potential of Coagulation-Related Biomarkers for Sepsis in the Emergency Department: Protocol for a Pilot Observational Cohort Study
description	Background:. Between 75% and 80% of patients with sepsis arrive in the hospital through the emergency department. Early diagnosis is important to alter patient prognosis, but currently, there is no reliable biomarker. The innate immune response links inflammation and coagulation. Several coagulation -related biomarkers are associated with poor prognosis in the ICU. The role of coagulation biomarkers to aid in early sepsis diagnosis has not previously been investigated. The objective of our study is to determine the individual or combined accuracy of coagulation and inflammation biomarkers with standard biochemical tests to diagnose adult septic patients presenting to the emergency department. Methods:. in the Emergency Department is a prospective, observational cohort study with a target enrolment of 250 suspected septic patients from two Canadian emergency departments. The emergency physicians will enroll patients with suspected sepsis. Blood samples will be collected at two time points (initial presentation and 4 hr following). Patients will be adjudicated into septic, infected, or not infected status in accordance with the Sepsis-3 definitions. Patient demographics, cultures, diagnosis, and biomarkers will be reported using descriptive statistics. Optimal cut off values with sensitivity and specificity for each biomarker will be determined using C-statistics to distinguish between septic and nonseptic patients. Stepwise multiple logistic regression analysis with exclusion of nonsignificant covariates from the final model will be used to establish a panel of biomarkers. Conclusions:. Our protocol describes the processes and methods for a pragmatic observational biomarker study in the emergency department. This study will seek to determine the potential diagnostic importance of early coagulation abnormalities to identify additional tools for sepsis diagnosis.
format	article
author	Jaskirat Arora, MBBS Jennifer A. Klowak, MD, MSc, FRCPC Sameer Parpia, MSc, PhD Marcelo Zapata-Canivilo, MD Walaa Faidi, MSc Christopher Skappak, MD, PhD Rachael Gregoris, BHSc Colin A. Kretz, BSc, PhD Dhruva J. Dwivedi, BSc, MSc, PhD Kerstin de Wit, BSc, MSc, MB ChB, MD, FRCPC, FRCEM, MRCP Michelle Welsford, BSc, MD, FACEP, CCPE, FRCPC Alison Fox-Robichaud, MSc, MD, FRCPC on behalf of the Canadian Critical Care Translational Biology Group Patricia Liaw Jamie Hutchison Jane Batt Sean Gill Jean-Francois Cailhier
author_facet	Jaskirat Arora, MBBS Jennifer A. Klowak, MD, MSc, FRCPC Sameer Parpia, MSc, PhD Marcelo Zapata-Canivilo, MD Walaa Faidi, MSc Christopher Skappak, MD, PhD Rachael Gregoris, BHSc Colin A. Kretz, BSc, PhD Dhruva J. Dwivedi, BSc, MSc, PhD Kerstin de Wit, BSc, MSc, MB ChB, MD, FRCPC, FRCEM, MRCP Michelle Welsford, BSc, MD, FACEP, CCPE, FRCPC Alison Fox-Robichaud, MSc, MD, FRCPC on behalf of the Canadian Critical Care Translational Biology Group Patricia Liaw Jamie Hutchison Jane Batt Sean Gill Jean-Francois Cailhier
author_sort	Jaskirat Arora, MBBS
title	Diagnostic Potential of Coagulation-Related Biomarkers for Sepsis in the Emergency Department: Protocol for a Pilot Observational Cohort Study
title_short	Diagnostic Potential of Coagulation-Related Biomarkers for Sepsis in the Emergency Department: Protocol for a Pilot Observational Cohort Study
title_full	Diagnostic Potential of Coagulation-Related Biomarkers for Sepsis in the Emergency Department: Protocol for a Pilot Observational Cohort Study
title_fullStr	Diagnostic Potential of Coagulation-Related Biomarkers for Sepsis in the Emergency Department: Protocol for a Pilot Observational Cohort Study
title_full_unstemmed	Diagnostic Potential of Coagulation-Related Biomarkers for Sepsis in the Emergency Department: Protocol for a Pilot Observational Cohort Study
title_sort	diagnostic potential of coagulation-related biomarkers for sepsis in the emergency department: protocol for a pilot observational cohort study
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/97e9fdeb85504be09052fd1bdf14f6b1
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Diagnostic Potential of Coagulation-Related Biomarkers for Sepsis in the Emergency Department: Protocol for a Pilot Observational Cohort Study

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