Diagnostic Potential of Coagulation-Related Biomarkers for Sepsis in the Emergency Department: Protocol for a Pilot Observational Cohort Study.
Early Warning Scores
a Disintegrin and Metalloprotease with ThromboSpondin type 1 motif
cell-free deoxyribonucleic acid
member 13 protein
neutrophil extracellular traps
protein C
von Willebrand factor
Journal
Critical care explorations
ISSN: 2639-8028
Titre abrégé: Crit Care Explor
Pays: United States
ID NLM: 101746347
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
entrez:
30
4
2021
pubmed:
1
5
2021
medline:
1
5
2021
Statut:
epublish
Résumé
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. 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. 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.
Sections du résumé
BACKGROUND
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
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
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.
Identifiants
pubmed: 33928260
doi: 10.1097/CCE.0000000000000414
pmc: PMC8078466
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e0414Informations de copyright
Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.
Déclaration de conflit d'intérêts
The authors have disclosed that they do not have any potential conflicts of interest.
Références
Physiol Rev. 2013 Jan;93(1):327-58
pubmed: 23303912
Blood. 2014 May 1;123(18):2768-76
pubmed: 24366358
Nat Rev Immunol. 2013 Jan;13(1):34-45
pubmed: 23222502
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
BMC Med Res Methodol. 2010 Jan 06;10:1
pubmed: 20053272
J Thromb Haemost. 2020 Apr;18(4):844-847
pubmed: 32073213
Ann Clin Biochem. 2018 Jan;55(1):143-148
pubmed: 28135842
Chest. 2017 Sep;152(3):518-526
pubmed: 28625579
Arterioscler Thromb Vasc Biol. 2015 Dec;35(12):2544-53
pubmed: 26494232
PLoS One. 2016 Mar 22;11(3):e0152065
pubmed: 27003588
Radiology. 1982 Apr;143(1):29-36
pubmed: 7063747
Crit Care. 2014 Nov 19;18(6):634
pubmed: 25407832
Crit Care. 2013 Oct 20;17(5):R244
pubmed: 24138799
BMC Infect Dis. 2019 Nov 12;19(1):968
pubmed: 31718563
J Thromb Haemost. 2018 Apr;16(4):646-651
pubmed: 29337416
J Thromb Haemost. 2020 Oct;18(10):2524-2531
pubmed: 32573898
Cancer. 1950 Jan;3(1):32-5
pubmed: 15405679
JAMA. 2016 Feb 23;315(8):801-10
pubmed: 26903338
Am J Respir Crit Care Med. 2017 Oct 1;196(7):856-863
pubmed: 28345952
Ann Intensive Care. 2017 Sep 6;7(1):91
pubmed: 28875483
Emerg (Tehran). 2017;5(1):e52
pubmed: 28286859
Eur J Emerg Med. 2014 Apr;21(2):112-7
pubmed: 23669296
CJEM. 2018 Mar;20(2):266-274
pubmed: 28487003
Crit Care Med. 2017 Sep;45(9):1443-1449
pubmed: 28817480
Lancet. 2020 Jan 18;395(10219):200-211
pubmed: 31954465
Crit Care Med. 2019 Aug;47(8):1018-1025
pubmed: 31107278
Crit Care Med. 2007 Aug;35(8):1928-36
pubmed: 17581480
Clin Chim Acta. 2017 Jan;464:6-11
pubmed: 27823951
Eur J Clin Invest. 2017 Apr;47(4):297-304
pubmed: 28155994
Clin Chem Lab Med. 2014 Oct;52(10):1465-72
pubmed: 24803611
JAMA. 2016 Feb 23;315(8):762-74
pubmed: 26903335
Exp Ther Med. 2019 Jun;17(6):4527-4535
pubmed: 31086585
Am J Respir Crit Care Med. 2016 Feb 1;193(3):259-72
pubmed: 26414292
Sci Rep. 2018 May 22;8(1):7985
pubmed: 29789571