Clinical Characteristics and Laboratory Biomarkers in ICU-admitted Septic Patients with and without Bacteremia

Fuente: arXiv
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Autores principales: Baek, Sangwon, Lee, Seung Jun
Formato: Preprint
Publicado: 2023
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author Baek, Sangwon
Lee, Seung Jun
author_facet Baek, Sangwon
Lee, Seung Jun
contents Few studies have investigated the diagnostic utilities of biomarkers for predicting bacteremia among septic patients admitted to intensive care units (ICU). Therefore, this study evaluated the prediction power of laboratory biomarkers to utilize those markers with high performance to optimize the predictive model for bacteremia. This retrospective cross-sectional study was conducted at the ICU department of Gyeongsang National University Changwon Hospital in 2019. Adult patients qualifying SEPSIS-3 (increase in sequential organ failure score greater than or equal to 2) criteria with at least two sets of blood culture were selected. Collected data was initially analyzed independently to identify the significant predictors, which was then used to build the multivariable logistic regression (MLR) model. A total of 218 patients with 48 cases of true bacteremia were analyzed in this research. Both CRP and PCT showed a substantial area under the curve (AUC) value for discriminating bacteremia among septic patients (0.757 and 0.845, respectively). To further enhance the predictive accuracy, we combined PCT, bilirubin, neutrophil lymphocyte ratio (NLR), platelets, lactic acid, erythrocyte sedimentation rate (ESR), and Glasgow Coma Scale (GCS) score to build the predictive model with an AUC of 0.907 (95% CI, 0.843 to 0.956). In addition, a high association between bacteremia and mortality rate was discovered through the survival analysis (0.004). While PCT is certainly a useful index for distinguishing patients with and without bacteremia by itself, our MLR model indicates that the accuracy of bacteremia prediction substantially improves by the combined use of PCT, bilirubin, NLR, platelets, lactic acid, ESR, and GCS score.
format Preprint
id arxiv_https___arxiv_org_abs_2311_08433
institution arXiv
publishDate 2023
record_format arxiv
spellingShingle Clinical Characteristics and Laboratory Biomarkers in ICU-admitted Septic Patients with and without Bacteremia
Baek, Sangwon
Lee, Seung Jun
Quantitative Methods
Machine Learning
Applications
Few studies have investigated the diagnostic utilities of biomarkers for predicting bacteremia among septic patients admitted to intensive care units (ICU). Therefore, this study evaluated the prediction power of laboratory biomarkers to utilize those markers with high performance to optimize the predictive model for bacteremia. This retrospective cross-sectional study was conducted at the ICU department of Gyeongsang National University Changwon Hospital in 2019. Adult patients qualifying SEPSIS-3 (increase in sequential organ failure score greater than or equal to 2) criteria with at least two sets of blood culture were selected. Collected data was initially analyzed independently to identify the significant predictors, which was then used to build the multivariable logistic regression (MLR) model. A total of 218 patients with 48 cases of true bacteremia were analyzed in this research. Both CRP and PCT showed a substantial area under the curve (AUC) value for discriminating bacteremia among septic patients (0.757 and 0.845, respectively). To further enhance the predictive accuracy, we combined PCT, bilirubin, neutrophil lymphocyte ratio (NLR), platelets, lactic acid, erythrocyte sedimentation rate (ESR), and Glasgow Coma Scale (GCS) score to build the predictive model with an AUC of 0.907 (95% CI, 0.843 to 0.956). In addition, a high association between bacteremia and mortality rate was discovered through the survival analysis (0.004). While PCT is certainly a useful index for distinguishing patients with and without bacteremia by itself, our MLR model indicates that the accuracy of bacteremia prediction substantially improves by the combined use of PCT, bilirubin, NLR, platelets, lactic acid, ESR, and GCS score.
title Clinical Characteristics and Laboratory Biomarkers in ICU-admitted Septic Patients with and without Bacteremia
topic Quantitative Methods
Machine Learning
Applications
url https://arxiv.org/abs/2311.08433