Background The prediction of infection and its severity remains difficult in

Background The prediction of infection and its severity remains difficult in the critically ill. CRP, PCT and ICIS were higher in groups 2 and 3 than group 1. The area under the receiver operating characteristic curve (AUROC) for the prediction of infection was 0.70 for order Evista CRP, 0.71 for PCT and 0.73 for ICIS (test and Fisher exact test were used to compare two groups. To evaluate predictive values we calculated the areas under the receiver operating characteristic curves (AUROC) for day 0 values. For the predictive values of sepsis and septic shock we used the values for day 0. We consider an AUROC 0. 70 as clinically relevant [22]. The optimum cutoff value was calculated on the basis of the highest sensitivity and specificity combined (Youden index). Positive and negative predictive values were calculated. To correct for multiple testing we set the level of statistical evidence at values 0.001 are given. Results Patient features Desk?1 describes the baseline features from the 301 sufferers enrolled: order Evista 149 sufferers (group 1) had no infections and 152 sufferers (groupings 2?+?3) had a possible or proven infections. Sufferers using a possible or established infections had been old and more regularly got a previous background of tumor, cardiac disease or gastrointestinal complications. Mechanical ventilation or renal replacement therapy was even more found in individuals using a possible or established infection often. All sufferers with a possible or proven infections had been on antibiotics. Simply no difference was observed in 28-time or 90-time mortality or in the distance of medical center or ICU stay. Desk 1 Baseline scientific and demographic features severe physiology and chronic wellness evaluation II, cardiopulmonary resuscitation, diabetes mellitus type II, extracorporeal membrane oxygenation, sequential body organ failure assessment rating, total parenteral diet Source of infections and microbial types The abdominal and lungs had been the Cd207 most typical source of infections (Desk?2). Gram-positive pathogens had been cultured mainly, accompanied by Gram-negative pathogens, fungi and infections (Desk?2). Desk 2 Infection characteristics C-reactive protein, intensive care infection score, procalcitonin, systemic inflammatory response syndrome, white blood cells Biomarkers Table?2 shows the infection markers according to invasiveness of contamination. Most patients had SIRS on day order Evista 0, so that the patients with contamination in groups 2 and 3 had mostly sepsis. CRP, PCT and ICIS were increased on days 0C2 in patients with infection as compared to those without contamination. In contrast to PCT, there was no difference in CRP and ICIS between groups 2 and 3. The CRP, PCT and ICIS were increased in patients with septic shock (Table?3). Table 3 Septic shock C-reactive protein, intensive care infection score, procalcitonin, white blood cells Predictive values The AUROC for the prediction of contamination (groups 2?+?3 vs group 1) on day 0 was comparable for CRP, PCT and ICIS (Table?4, Fig.?1). At a cutoff 7, the positive predictive value of ICIS was 80?% and at a cutoff 1 the unfavorable predictive value of ICIS was 80?%. Otherwise, the AUROC for ICIS did not differ from that of any other biomarkers, including PCT, expect for that of WBC (area under the receiver operating characteristic curve, confidence interval, C-reactive protein, intensive care infection score, procalcitonin, positive predictive value, negative predictive value, white blood cells. The AUROC for ICIS differed from that for WBC ( em P /em ? ?0.001) Open in a separate window Fig. 1 Area under the receiver operating characteristic curve for the four biomarkers for the prediction of contamination: for white blood cell count ( em WBC /em ) 0.53, for C-reactive protein ( em CRP /em ) 0.70,.