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The Dynamical Assessment of Inflammatory Biomarkers in Predicting the Outcome of Septic Patients and the Response to Antimicrobial Therapy

Alina Orfanu
Alina Orfanu
, 
Victoria Aramă
Victoria Aramă
, 
Cristina Popescu
Cristina Popescu
, 
Cătălin Tilişcan
Cătălin Tilişcan
, 
Adrian Streinu-Cercel
Adrian Streinu-Cercel
 and 
Ştefan Sorin Aramă
Ştefan Sorin Aramă
   | Jan 31, 2020
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Article Category: Research Article
Published Online: Jan 31, 2020
Page range: 25 - 31
Received: Nov 02, 2019
Accepted: Jan 29, 2020
DOI: https://doi.org/10.2478/jccm-2020-0004
Keywords
© 2020 Alina Orfanu, Victoria Aramă, Cristina Popescu, Cătălin Tilişcan, Adrian Streinu-Cercel, Ştefan Sorin Aramă, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Fig. 1

The differences between the levels of serum biomarkers on days 0, 1 and 3. A. NLCR time course. Day 0 – Day 1 difference, p<0.0001; Day 0 – Day 3 difference, p<0.0001; Day 1 – Day 3 difference, p<0.0001. B. FIB time course. Day 0 – Day 1 difference, p=0.064; Day 0 – Day 3 difference, p<0.0001; Day 1 – Day 3 difference, p<0.0001. C. CRP time course. Day 0 – Day 1 difference, p=0.449; Day 0 – Day 3 difference, p<0.001; Day 1 – Day 3 difference, p<0.001. C. PCT time course. Day 0 – Day 1 difference, p<0.001; Day 0 – Day 3 difference, p=0.001; Day 1 – Day 3 difference, p<0.001. NLCR, Neutrophil/lymphocyte count ratio; FIB, fibrinogen; CRP, C-reactive protein; PCT, procalcitonin.
The differences between the levels of serum biomarkers on days 0, 1 and 3. A. NLCR time course. Day 0 – Day 1 difference, p<0.0001; Day 0 – Day 3 difference, p<0.0001; Day 1 – Day 3 difference, p<0.0001. B. FIB time course. Day 0 – Day 1 difference, p=0.064; Day 0 – Day 3 difference, p<0.0001; Day 1 – Day 3 difference, p<0.0001. C. CRP time course. Day 0 – Day 1 difference, p=0.449; Day 0 – Day 3 difference, p<0.001; Day 1 – Day 3 difference, p<0.001. C. PCT time course. Day 0 – Day 1 difference, p<0.001; Day 0 – Day 3 difference, p=0.001; Day 1 – Day 3 difference, p<0.001. NLCR, Neutrophil/lymphocyte count ratio; FIB, fibrinogen; CRP, C-reactive protein; PCT, procalcitonin.

Fig. 2

Comparison of proportions of NLCR, FIB, CRP and PCT between days 0 and 1. 1 – patients who registered an increasing or a minor decreasing (<5% of the initial values) of serum biomarkers; 2 – patients who registered a decreasing of serum biomarkers between 5-20%; 3 – patients who registered a decreasing of serum biomarkers between 20-50%; 4 – patients who registered a major decreasing (>50%) of serum biomarkers. NLCR, Neutrophil/lymphocyte count ratio; FIB, fibrinogen; CRP, C-reactive protein; PCT, procalcitonin.
Comparison of proportions of NLCR, FIB, CRP and PCT between days 0 and 1. 1 – patients who registered an increasing or a minor decreasing (<5% of the initial values) of serum biomarkers; 2 – patients who registered a decreasing of serum biomarkers between 5-20%; 3 – patients who registered a decreasing of serum biomarkers between 20-50%; 4 – patients who registered a major decreasing (>50%) of serum biomarkers. NLCR, Neutrophil/lymphocyte count ratio; FIB, fibrinogen; CRP, C-reactive protein; PCT, procalcitonin.

Fig. 3

Comparison of proportions of NLCR, FIB, CRP and PCT between days 1 and 3. 1 – patients who registered an increasing or a minor decreasing (<5% of the value at 24 hours) of serum biomarkers; 2 – patients who registered a decreasing of serum biomarkers between 5-20%; 3 – patients who registered a decreasing of serum biomarkers between 20-50%; 4 – patients who registered a major decreasing (>50%) of serum biomarkers. NLCR, Neutrophil/lymphocyte count ratio; FIB, fibrinogen; CRP, C-reactive protein; PCT, procalcitonin.
Comparison of proportions of NLCR, FIB, CRP and PCT between days 1 and 3. 1 – patients who registered an increasing or a minor decreasing (<5% of the value at 24 hours) of serum biomarkers; 2 – patients who registered a decreasing of serum biomarkers between 5-20%; 3 – patients who registered a decreasing of serum biomarkers between 20-50%; 4 – patients who registered a major decreasing (>50%) of serum biomarkers. NLCR, Neutrophil/lymphocyte count ratio; FIB, fibrinogen; CRP, C-reactive protein; PCT, procalcitonin.

Fig. 4

Comparison of proportions of NLCR, FIB, CRP and PCT between days 0 and 3. 1 – patients who registered an increasing or a minor decreasing (<5% of the initial value) of serum biomarkers; 2 – patients who registered a decreasing of serum biomarkers between 5-20%; 3 – patients who registered a decreasing of serum biomarkers between 20-50%; 4 – patients who registered a major decreasing (>50%) of serum biomarkers. NLCR, Neutrophil/lymphocyte count ratio; FIB, fibrinogen; CRP, C-reactive protein; PCT, procalcitonin.
Comparison of proportions of NLCR, FIB, CRP and PCT between days 0 and 3. 1 – patients who registered an increasing or a minor decreasing (<5% of the initial value) of serum biomarkers; 2 – patients who registered a decreasing of serum biomarkers between 5-20%; 3 – patients who registered a decreasing of serum biomarkers between 20-50%; 4 – patients who registered a major decreasing (>50%) of serum biomarkers. NLCR, Neutrophil/lymphocyte count ratio; FIB, fibrinogen; CRP, C-reactive protein; PCT, procalcitonin.

The dynamical values of NLCR, FIB, CRP and PCT on days 0, 1 and 3. The results are presented as median (IQR).

VariableAdmission (day 0)After 24 hours (day 1)After 72 hours (day 3)
NLCR13.4 (6; 22.8)6.14 (3.7; 12.86)3.63 (2.49; 5.98)
FIB (mg/dl)606 (475; 753)564 (474; 730)474 (385; 616)
CRP (mg/l)157 (102; 232)169 (73; 212)58.4 (23.5; 109)
PCT (ng/dl)4.36 (0.51; 22.71)3.34 (0.36; 22.06)0.78 (0.05; 4.77)
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