Lengquist Maria, Sundén-Cullberg Vera, Hyllner Sofie, Koozi Hazem, Larsson Anders, Mellhammar Lisa, Friberg Hans, Schiopu Alexandru, Frigyesi Attila
Department of Clinical Medicine, Lund University, Lund, Sweden.
Department of Anaesthesia and Intensive Care, Skåne University Hospital, Lund, Sweden.
Sci Rep. 2025 May 3;15(1):15529. doi: 10.1038/s41598-025-95420-0.
Diagnosing sepsis in critical care remains a challenge due to the lack of gold-standard diagnostics. Calprotectin (S100A8/A9) has been proposed as a diagnostic marker to identify sepsis in critically ill patients. This study evaluated the diagnostic performance of calprotectin and C-reactive protein (CRP) to distinguish between sepsis and non-sepsis on intensive care unit (ICU) admission. Admission biobank blood samples from adult patients admitted to four ICUs (2015-2018) were used to analyse calprotectin and CRP. All adult patients were screened retrospectively for the sepsis-3 criteria at ICU admission. The diagnostic performance of calprotectin and CRP was evaluated using receiver operating characteristic (ROC) curves. We included 4732 patients, of whom 44% had sepsis. Calprotectin levels were higher in sepsis (p < 0.001). The area under the receiver operating curve (AUROC) to diagnose sepsis was 0.61 for calprotectin compared to 0.72 for CRP (p < 0.001). Among microbiological subgroups of sepsis patients, fungal sepsis had the highest level of calprotectin. We conclude that the diagnostic performance of calprotectin in identifying sepsis patients at ICU admission was inferior to that of CRP.
由于缺乏金标准诊断方法，在重症监护中诊断脓毒症仍然是一项挑战。钙卫蛋白（S100A8/A9）已被提议作为一种诊断标志物，用于识别重症患者中的脓毒症。本研究评估了钙卫蛋白和C反应蛋白（CRP）在重症监护病房（ICU）入院时区分脓毒症和非脓毒症的诊断性能。使用来自四个ICU（2015 - 2018年）收治的成年患者的入院生物样本库血样来分析钙卫蛋白和CRP。对所有成年患者在ICU入院时进行回顾性筛查，以确定是否符合脓毒症-3标准。使用受试者工作特征（ROC）曲线评估钙卫蛋白和CRP的诊断性能。我们纳入了4732例患者，其中44%患有脓毒症。脓毒症患者的钙卫蛋白水平更高（p < 0.001）。钙卫蛋白诊断脓毒症的受试者工作特征曲线下面积（AUROC）为0.61，而CRP为0.72（p < 0.001）。在脓毒症患者的微生物亚组中，真菌性脓毒症的钙卫蛋白水平最高。我们得出结论，钙卫蛋白在ICU入院时识别脓毒症患者的诊断性能不如CRP。
