Exploration of sepsis assisting parameters in hospital autopsied-patients: a prospective study.

Autor: Inai K; Division of Molecular Pathology, Department of Pathological Sciences, School of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan. kinai@u-fukui.ac.jp., Higuchi S; Division of Molecular Pathology, Department of Pathological Sciences, School of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan., Shimada A; Division of Infection Control, University of Fukui Hospital, Fukui, Japan., Hisada K; Division of Infection Control, University of Fukui Hospital, Fukui, Japan., Hida Y; Division of Infection Control, University of Fukui Hospital, Fukui, Japan., Hatta S; Division of Molecular Pathology, Department of Pathological Sciences, School of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan., Kitano F; Division of Rural Medicine, School of Medical Sciences, University of Fukui, Fukui, Japan., Uno M; Department of Pharmacy, University of Fukui Hospital, Fukui, Japan., Matsukawa H; Division of Molecular Pathology, Department of Pathological Sciences, School of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan., Noriki S; Faculty of Nursing and Social Welfare Sciences, Fukui Prefectural University, Fukui, Japan., Iwasaki H; Division of Infection Control, University of Fukui Hospital, Fukui, Japan., Naiki H; Division of Molecular Pathology, Department of Pathological Sciences, School of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2023 Jul 01; Vol. 13 (1), pp. 10681. Date of Electronic Publication: 2023 Jul 01.
DOI: 10.1038/s41598-023-37752-3
Abstrakt: Although Sepsis-3 doesn't require evidence of bacteremia to diagnose sepsis, clinicians often want to identify the causative pathogen at autopsy. In principle, if the blood cultures are the same at ante- and postmortem, the cause of death is obvious. However, interpretations of postmortem blood cultures are often difficult due to discordance, negativity, mixed infection, and contamination, of pathogens occupying ≥ 50% of the tests. To increase specificity identifying agonal phase sepsis in the situations where blood cultures are discordant, multiple or negative at postmortem, we established a scoring system using blood cultures, procalcitonin (PCN) showing highest sensitivity and specificity for postmortem serum, and bone marrow polyhemophagocytosis (PHP). Histological sepsis showed significantly higher levels of culture score (2.3 ± 1.5 vs. 0.4 ± 0.5, p < 0.001), PHP score (2.5 ± 0.8 vs. 1.0 ± 1.1, p < 0.001), and PCN score (1.8 ± 0.8 vs. 0.8 ± 0.6, p < 0.01) than non-septic patients. Receiver operating characteristic curve analysis indicated that estimation of three scores was the most reliable indicator for recognizing agonal phase sepsis. These findings suggest that the combination of these three inspections enables to determine the pathological diagnoses of sepsis even it is not obvious by discordant, mixed or negative blood cultures.
(© 2023. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje