Table 5.
Diagnostic performance of combination biomarkers
| Biomarker(s) | Sample size (n) | Notes | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | Cut-off value | Reference |
|---|---|---|---|---|---|---|---|---|
| CRP |
192 |
*reported for culture positive cases |
80 |
71 |
43 |
93 |
0.4mg/L |
51 |
| CRP+sICAM-1, SAA, and sE-selectin |
85 |
67 |
94 |
41 |
0.4mg/L, 249ng/mL, 1mg/L, 132mg/L |
|||
| CRP+ sICAM-1 |
72 |
75 |
44 |
91 |
0.4mg/L, 249ng/mL |
|||
| CRP |
*reported for culture positive and culture negative, clinically suspected sepsis cases |
69 |
70 |
60 |
79 |
0.4mg/L |
||
| CRP+sICAM-1, SAA, and sE-selectin |
90 |
67 |
64 |
91 |
0.4mg/L, 228ng/mL, 1mg/L, 132mg/L |
|||
| CRP+ sICAM-1 |
79 |
76 |
68 |
85 |
0.4mg/L, 228ng.mL |
|||
| sTREM-1 |
52 |
70 |
71 |
62 |
78 |
144pg/mL |
75 |
|
| IL-6 |
80 |
81 |
74 |
86 |
66pg/mL |
|||
| sTREM-1 + IL-6 |
90 |
62 |
81 |
77 |
144pg/mL, 66pg/mL |
|||
| PCT |
98 |
65 |
60 |
52 |
59 |
63.4 pg/mL |
77 |
|
| IL-10 |
92 |
84 |
80 |
89 |
17.3 pg/mL |
|||
| nCD64 |
92 |
71 |
69 |
83 |
2.6% |
|||
| IL-10 + nCD64 |
95 |
83 |
79 |
86 |
17.3 pg/mL, 2.6% |
|||
| PCT + IL-10 |
75 |
68 |
53 |
64 |
36.4 pg/mL, 17.3 pg/mL |
|||
| PCT + nCD-64 |
78 |
64 |
58 |
69 |
36.4 pg/mL, 2.6% |
|||
| ApoC2/SAA |
104 |
*at day 0 |
96 |
76 |
82 |
95 |
0.199 |
57 |
| *day 0 and day 1 |
100 |
61 |
75 |
100 |
0.199 |
|||
| CRP |
120 |
86 |
97 |
96 |
88 |
8 mg/L |
52 |
|
| sE-selectin |
59 |
87 |
81 |
69 |
130 ng/mL |
|||
| CRP + sE-selectin |
45 |
100 |
100 |
65 |
8 mg/L, 130 ng/mL |
|||
| PCT |
123 |
21 |
92 |
46 |
79 |
25 ng/mL |
64 |
|
| 69 |
67 |
39 |
87 |
5.75 ng/mL |
||||
| IL-6 |
57 |
94 |
76 |
88 |
250 pg/mL |
|||
| 71 |
71 |
43 |
89 |
12 pg/mL |
||||
| PCT + IL-6 |
71 |
88 |
65 |
91 |
25ng/mL, 250 pg/mL |
|||
| IP-10 |
155 |
93 |
89 |
77 |
97 |
1250 pg/mL |
35 |
|
| IP-10 +IL-6 |
98 |
72 |
58 |
99 |
1250 pg/mL, 26.1 pg/mL |
|||
| IP-10 + IL-6 + IL-10 |
98 |
61 |
50 |
99 |
1250 pg/mL, 26.1 pg/mL, 7.6 pg/mL |
|||
| IP-10 + IL-10 |
98 |
76 |
61 |
99 |
1250 pg/mL, 7.6 pg/mL |
|||
| IP-10 + GRO-α |
96 |
58 |
47 |
97 |
1250 pg/mL, 55 pg/mL |
|||
| IP-10 + GRO-α +IL-8 |
100 |
39 |
39 |
100 |
1250 pg/mL, 55 pg/mL, 62 pg/mL |
|||
| IP-10 + IL-8 |
98 |
53 |
45 |
98 |
1250 pg.mL, 62 pg/mL |
|||
| IP-10 + IL-8 + MIG |
98 |
44 |
41 |
98 |
1250 pg.mL, 62 pg/mL, 650 pg/mL |
|||
| IP-10 + MIG |
93 |
76 |
60 |
97 |
1250 pg/mL, 650 pg/mL |
|||
| IP-10 + GRO-α + IL-10 |
98 |
51 |
44 |
98 |
1250 pg/mL, 55pg/mL, 7.6pg/mL |
|||
| IP-10 + GRO-α + MIG |
96 |
47 |
42 |
96 |
1250 pg/mL, 55 pg/mL, 650 pg/mL |
|||
| CRP |
77 |
96 |
89 |
79 |
98 |
5 mg/L |
70 |
|
| IL-6 |
35 |
93 |
67 |
76 |
150 pg/mL |
|||
| CRP + IL-6 |
35 |
100 |
100 |
78 |
5 mg/L, 150 pg/mL |
|||
| CRP and/or IL-6 |
96 |
82 |
69 |
98 |
5 mg/L, 150 pg/mL |
|||
| CRP |
111 |
65 |
52 |
63 |
54 |
14 mg/L |
76 |
|
| CRP + IL-6 |
92 |
41 |
67 |
80 |
14 mg/L, 60 pg/mL |
|||
| CRP + IL-8 |
97 |
41 |
68 |
92 |
14 mg/L, 50 pg/mL |
|||
| CRP |
1291 |
54 |
86 |
10 mg/L |
68 |
|||
| IL-8 |
44 |
90 |
58 |
83 |
70 pg/mL |
|||
| CRP + IL-8 |
80 |
87 |
68 |
93 |
10 mg/L, 70pg/mL |
|||
| CRP |
359 |
*at 0 hours |
49 |
91 |
73 |
77 |
10 mg/L |
67 |
| CD64 |
79 |
89 |
78 |
89 |
6136 antibody-PE molecules bound/cell |
|||
| CRP + CD64 |
81 |
82 |
69 |
89 |
10 mg/L, 6136 antibody-PE molecules bound/cell |
|||
| CRP |
*at 24 hours |
60 |
83 |
64 |
80 |
10 mg/L |
||
| CD64 |
96 |
81 |
71 |
97 |
6136 antibody-PE molecules bound/cell |
|||
| CRP + CD64 |
97 |
71 |
73 |
98 |
10 mg/L, 6136 antibody-PE molecules bound/cell |
|||
| CRP |
105 |
*at 0 hours |
69 |
96 |
93 |
80 |
10 mg/dL |
71 |
| IL-6 |
76 |
73 |
67 |
81 |
18 pg/mL |
|||
| IL-8 |
75 |
66 |
60 |
80 |
100 pg/mL |
|||
| CRP + IL-6 |
89 |
73 |
70 |
90 |
10 mg/dL, 18 pg/mL |
|||
| CRP + IL-8 |
89 |
66 |
65 |
90 |
10 mg/dL, 100 pg/mL |
|||
| CRP |
*at 24 hours |
78 |
94 |
91 |
83 |
10 mg/dL |
||
| IL-6 |
63 |
76 |
74 |
66 |
18 pg/mL |
|||
| IL-8 |
49 |
79 |
71 |
59 |
100 pg/mL |
|||
| CRP + IL-6 |
83 |
78 |
75 |
84 |
10 mg/dL, 18 pg/mL |
|||
| CRP + IL-8 |
76 |
79 |
79 |
83 |
10 mg/dL, 100 pg/mL |
|||
| CRP |
76 |
49 |
100 |
100 |
58 |
8 mg/L |
78 |
|
| PCT |
77 |
91 |
93 |
72 |
6 ng/mL |
|||
| PCT + CRP |
83 |
8 mg/L |
||||||
| PCT + IL-6 |
89 |
8 mg/L |
||||||
| CRP |
60 |
80 |
92 |
1.52 mg/dL |
74 |
|||
| CRP + IL-8 +sReceptor IL-2 |
85 |
97 |
1.52 mg/dL, 63 pg/mL, 2780U/mL |
|||||
| CRP |
110 |
*at 0 hours |
65 |
99 |
96 |
87 |
12 mg/L |
73 |
| IL-6 |
78 |
92 |
81 |
91 |
31 pg/mL |
|||
| CD64 |
95 |
88 |
80 |
97 |
4000 PE molecules bound/cell |
|||
| CRP |
*at 24 hours |
72 |
100 |
100 |
90 |
12 mg/L |
||
| IL-6 |
44 |
93 |
72 |
81 |
31 pg/mL |
|||
| CD64 |
97 |
90 |
80 |
99 |
4000 PE molecules bound/cell |
|||
| CRP(0 hr) + IL-6(0 hr) + CD64(24hr) |
100 |
86 |
74 |
100 |
12 mg/L, 31 pg/mL, 4000 PE molecules bound/cell |
|||
| CRP |
166 |
63 |
89 |
10 mg/L |
66 |
|||
| IL-6 |
78 |
64 |
20 pg/mL |
|||||
| CRP +/or IL-6 |
96 |
58 |
10 mg/mL, 20 pg/mL |
|||||
| CRP |
90 |
69 |
86 |
84 |
73 |
5 mg/L |
69 |
|
| sICAM-1 |
78 |
90 |
90 |
80 |
300µg/mL |
|||
| CRP + sICAM-1 |
93 |
80 |
82 |
92 |
5 mg/L, 300µg/mL |
|||
| CRP |
101 |
60 |
100 |
100 |
75 |
12 mg/L |
79 |
|
| IL-6 |
89 |
96 |
95 |
91 |
31 pg/mL |
|||
| TNF-α |
82 |
86 |
82 |
85 |
17 pg/mL |
|||
| CRP + IL-6 |
93 |
95 |
95 |
95 |
12 mg/L, 31 pg/mL |
|||
| CRP + TNF-α |
91 |
86 |
84 |
92 |
12 mg/L, 17 pg/mL |
|||
| IL-6 + TNF-α |
95 |
84 |
83 |
96 |
31 pg/mL, 17 pg/mL |
|||
| CRP + IL-6 + TNF-α |
95 |
84 |
82 |
96 |
12 mg/L, 31 pg/mL, 17 pg/mL |
|||
| IL-6 |
55 |
80 |
78 |
500 pg/mL |
65 |
|||
| TNF-α |
73 |
94 |
70 pg/mL |
|||||
| IL-6 + TNF-α |
60 |
100 |
500 pg/mL, 70 pg/mL |
|||||
CRP – C-reactive protein, IL – interleukin, sICAM -1 – soluble intercellular adhesion molecule-1, SAA – serum amyloid A, IL-12p70 – IL-12 protein 70, sTREM-1 – soluble triggering receptor expressed on myeloid cells, ApoC2 – apolipoprotein C-II, GRO-a – growth-related oncogene-a, MIG – monokine induced by interferon g, PCT – procalcitonin, TNF – tumor necrosis factor, PPV – positive predictive value, NPV – negative predictive value, PE – phycoerythrin