Table 1.
Biomarker risk stratification panels for mortality in pediatric sepsis.
| Article (Region) | Stratification | Biomarker | Other features (number) | Sample characterization | Method | Note |
|---|---|---|---|---|---|---|
| Assicot M et al. 1993 (France) | Subgroup I | Procalcitonin (PCT) | Clinical history and blood culture (2) | 79 children with varying degrees of infection or severe burns; PICU | Laboratory tests (assays and HPLC) | A positive correlation of procalcitonin with severity of infection. Up to 200 ng/ml in patients with septic shock and Antibiotic treatment lowers procalcitonin rapidly to normal levels. |
| Subgroup II | ||||||
| Subgroup III | ||||||
| Ramos Garcia et al. 2007 (Brazil) | Ferritin | Sex, age, nutrition level, mechanical ventilation, days out of PICU in the 28 days after admission, PRISM, PELOD, blood culture, WBC count, alanine transaminase, aspartate transaminase, CRP (12) | 36 patients with severe sepsis and septic shock; < 15 years old; PICU | Logistic regression analysis | A concentration of serum ferritin >500 ng/ml is associated with a 3.2 relative risk of death. Sensitivity: 64% Specificity: 80% | |
| Lin JJ et al. 2017 (Taiwan) | Serum Thrombomodulin | Age, gender, site of infection, laboratory findings, mechanical ventilation, vasopressor use, severity of disease on day1, PRISM-III, PELOD, P-MOD, stay in PICU and hospitalization days, mortality DIC scores (14) | 42 previously healthy patients with sepsis; PICU | AUC-ROC | Concentration on day 1 of diagnosis of sepsis can predict development of septic shock (AUC = 0.867, 4.71 mU/ml) and mortality (AUC = 0.863, 5.95 mU/ml). | |
| Wong et al. 2008 (USA) | IL-8 < 220 pg/ml | IL-8 | Age, sex, adverse events days, death, PRISM (4) | pediatric septic shock databases:GPSS (<10 years) and RESOLVE (<18 years); 278 patients with septic shock | AUC-ROC, statistical analysis (Student's T test, Fisher exact test, chi-square test, contingency tables) | A serum IL-8 (>220 pg/ml) predicts 28-day mortality. Sensitivity: 82% Specificity: 51% |
| IL-8 > 220 pg/ml | ||||||
| Tonial et al. 2021 (Brazil) | CRP, ferritin, lactate, PIM2 | 24 h leukocytes, age, sex, weight, type of patient, BMI, 72 h readmission to PICU, site of infection, type of infection, length of hospital stay, length of PICU stay, complete blood count, blood transfusion, mechanical ventilation, vasoactive drugs, ventilator-free days, vasoactive drug-free days, presence of complications, anemia, iron-deficiency anemia, comorbidities, death (22) | 294 septic patients; <19 years >1 month; PICU | AUC-ROC, Kaplan-Meier survival curves | Alone they were associated with mortality, cutoff PIM2 (> 14%), ferritin (>135 ng/ml), and CRP (> 6.7 mg/ml) were associated with mortality. Combination: Sensitivity: 76% Selectivity: 94.5% |