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Simplified Diagnosis of Urosepsis by Emergency Ultrasound Combined with Clinical Scores and Biomarkers Cover

Figures & Tables

Fig. 1.

Comparison between computerised tomography (CT) and ultrasound evaluation (US) regarding the number of patients diagnosed with urosepsis shows the non-inferiority of US vs CT (RR=0.944, 95%CI = 0.852–1.045, p=0.264).

Fig. 2.

Correlation scatter graphs and heat-maps for the 2 prognostic scores (SOFA - Sequential Organ Failure Assessment and NEWS - National Early Warning Score, r = 0.793, 95%CI = 0.692 – 0.864, p < 0.0001) as well as the two important markers (PCT and NLR, r = 0.417, 95%CI = 0.211 – 0.587, p=0.0002) show strong and significant correlations.

Fig. 3.

ROC curve comparison for all study parameters: SOFA, NEWS, PCT, NLR, CRP. (SOFA - Sequential Organ Failure Assessment, NEWS - National Early Warning Score, PCT – procalcitonin, NLR - neutrophil-to-lymphocyte ratio, CRP – C-reactive protein).

Patient demographic and biological parameters and scores with comparison between those with sepsis and septic shock_

ParameterTotal (n=76)Urosepsis (n= 61)Septic Shock (n=15)p=
Age (years)63.4 ±15.161.7 ±15.770.3 ±10.20.015*
Sex (M/F)52/2443/189/60.433#
SOFA score6.1 ± 3.25.3 ± 2.39.4 ± 2.9< 0.001*
NEWS9.8 ± 2.99.1 ± 2.312.6 ± 3.40.0013*
GCS12.4 ±1.712.7 ±1.611.2 ±1.70.005*
MAP (mmHg)80 ± 1183 ± 967 ± 6< 0.001*
HR (beats/min)82 ± 1878 ± 1398 ± 280.019*
RR (breaths/min)23 ± 723 ± 723 ± 70.027*
WBC (×103/mm3)18 [15–22]17 [14–20]21 [19–23]0.412^
NEU (×103/mm3)15 [13–18]14 [12–17]18 [15–19]0.313^
LYM (×103/mm3)1.6 [1.2–2.1]1.6 [1.3–2.1]1.5 [1.2–1.8]0.596^
NLR10.3 ± 3.29.8 ± 3.012.2 ± 3.40.023*
PLT (×103/mm3)133 ± 49140 ± 50108 ± 320.042*
C-Reactive Protein (mg/l)124 [92–145]124 [94–143]136 [79–153]0.697^
Procalcitonin (PCT) (ng/ml)13.0 ±5.711.8 ±4.618.0 ±7.40.007*
ESR (mm/h)40.4 ±16.438.9 ±16.942.3 ±14.90.587*
Lactate (mmol/l)1.8 ± 1.41.6 ± 1.22.7 ± 1.80.039*
Creatinine (mg/dl)1.9 ± 1.31.9 ± 1.42.1 ± 1.10.619*
Bilirubin (mg/dl)1.8 ± 1.01.7 ± 1.02.2 ± 0.90.085*

Comparison of AUC values with standard error (SE), 95%CI of AUC, Sensitivity (Sn), Specificity (Sp), cut-off value and statistical significance (p) for all analysed parameters: SOFA - Sequential Organ Failure Assessment, NEWS - National Early Warning Score, PCT – procalcitonin, NLR - neutrophil-to-lymphocyte ratio, CRP – C-reactive protein_

VariableAUCSE95% CISnSpCut-offp=
SOFA0.8740.0430.778 to 0.93987%72%6<0.0001
NEWS0.7910.0650.682 to 0.87667%74%10<0.0001
PCT0.7430.0800.629 to 0.83667%74%13.60.0025
NLR0.7170.0720.603 to 0.81580%62%9.90.0023
CRP0.5430.0990.425 to 0.65867%59%1270.664
DOI: https://doi.org/10.2478/jccm-2024-0006 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809
Language: English
Page range: 30 - 37
Submitted on: Nov 4, 2023
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Accepted on: Dec 10, 2023
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Published on: Jan 30, 2024
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2024 Alice Nicoleta Dragoescu, Petru Octavian Dragoescu, Andreea Doriana Stanculescu, Vlad Padureanu, Dalia Dop, Mihai Alexandru Radu, Mirela Marinela Florescu, Daniela Teodora Maria, Dan Nicolae Florescu, George Mitroi, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.