A new tool for sepsis screening in the Emergency Department

Bruna Lo Sasso, Luisa Agnello, Concetta Scazzone, Caterina Maria Gambino, Marcello Ciaccio, Giulia Bivona, Rosaria Vincenza Giglio, Marcello Ciaccio, Bruna Lo Sasso, Alessandro Iacona, Anna Maria Ciaccio, Matteo Vidali, Alessandro Iacona, Anna Maria Ciaccio, Michele Pantuso

Risultato della ricerca: Articlepeer review

Abstract

In this study, we developed and evaluated the diagnostic accuracy of the Sepsis Index for early sepsis screening in the Emergency Department (ED). Sepsis Index is based on the combination of monocyte distribution width (MDW) and mean monocyte volume (MMV). Sepsis Index≥1 was selected to define sepsis. We tested its diagnostic accuracy in an ED population stratified in four groups: Controls, Systemic Inflammatory Response Syndrome (SIRS), infection, and sepsis, according to Sepsis-2 criteria. Patients with sepsis displayed higher median Sepsis Index value than patients without sepsis. At the receiver operating characterictis (ROC) curve analysis for the prediction of sepsis, the area under the curve (AUC) of MDW and Sepsis Index were similar: 0.966 (95%CI 0.947-0.984), and 0.964 (95%CI 0.942-0.985), respectively. Sepsis Index showed increased specificity than MDW (94.7 vs. 90.6%), without any decrease in sensitivity (92.0%). Additionally, LR+ increased from 9.8 (MDW) to 17.4 (Sepsis Index), without any substantial change in LR-(respectively 0.09 vs. 0.08). Finally, PPV increased from 0.286 (MDW) to 0.420 (Sepsis Index). Sepsis Index improves the diagnostic accuracy of MDW alone for sepsis screening.
Lingua originaleEnglish
pagine (da-a)1600-1605
Numero di pagine6
RivistaClinical Chemistry and Laboratory Medicine
Volume59
Stato di pubblicazionePublished - 2021

All Science Journal Classification (ASJC) codes

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  • ???subjectarea.asjc.2700.2704???

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