Table 2.
Role of biomarkers in urosepsis.
| Biomarker | Cutoff | Specificity (%) | Sensitivity (%) | AUC | Use time | Function | Concerns | References |
|---|---|---|---|---|---|---|---|---|
| WBC | >14.05 × 109/L | Postoperative | We should not only focus on abnormally elevated WBC counts in the blood; but also be more alert to sharp declines in WBC, as it may indicate severe sepsis | Bozkurt et al.5 | ||||
| <2.85 × 109/L | 92.7 | 95.9 | Within 2 h after intracorporeal lithotripsy | Predicts urosepsis shock | Previous works6–9 | |||
| NLR | >2.5 | _ | _ | 0.58 | Preoperative | Predicts urosepsis, differentiate between urosepsis and non-urosepsis | NLR is superior to pure blood WBC counts in predicting infection
severity. It is simple, easily measured, and easy to use in daily practice. |
Sen et al.10 |
| >5 | 57.8 | 83.9 | 0.66 | Postoperative | Gürol et al.11 | |||
| IL-6 | – | 78 | 68 | 0.80 | Postoperative 2 h | Diagnosis of urosepsis | IL-6 was the most effective inflammatory biomarker for diagnosing urosepsis at postoperative 2 h. | Previous works12,13 |
| PCT | _ | _ | _ | _ | 4 h after infection | Distinguish between bacterial sepsis and non-bacterial
sepsis. PCT can judge the severity of urosepsis and guide treatment. |
Should be combined with the clinical feature of
patients. Lack of clear cut-off value. Extra costs. |
Previous works14–17 |
| CRP | ⩾151.9 ng/mL | 73.9 | 60.2 | 0.699 | 12–24 h after infection | Assist in diagnosis of urosepsis | Higher CRP means higher mortality | Previous works18,19 |
| Lac | ⩾4 mmol/L | 92 | 35 | 0.63 | Beginning of urosepsis | Tools for screening and management of
urosepsis. Predicted mortality. |
Lac normalized within 6 h after fluid resuscitation can reduce
patient mortality. Look for the cause of Lac elevations. |
Previous works20–24 |
| LncRNAs | _ | _ | _ | _ | 2–24 h after urosepsis | Diagnosis of urosepsis Judge prognosis |
Attention to the mechanism of LncRNAs in urosepsis. | Previous works25,26 |
| PTX3 | 15.877 ng/mL | 100 | 50 | 0.798 | Beginning of urosepsis or after surgery (day 1) | Predicting the severity of septic shock | Beware of septic shock when PTX3 level rises sharply. | Previous works27,28 |
| PD-L1 | >121.5 pg/mL | 96.6 | 92.2 | 0.973 | Beginning of urosepsis | Diagnosis of urosepsis | Need combination with the sequential organ failure assessment (SOFA) score. |
Previous works29–31 |
CRP, C-reactive protein; NLR, neutrophil to lymphocyte ratio; PCT, predictive comparisons of procalcitonin; SOFA, Sequential Organ Failure Assessment; WBC, white blood cell. All samples can be obtained from serum.