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Exploration of sepsis assisting parameters in hospital autopsied-patients: a prospective study
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 cult...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314941/ https://www.ncbi.nlm.nih.gov/pubmed/37393368 http://dx.doi.org/10.1038/s41598-023-37752-3 |
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author | Inai, Kunihiro Higuchi, Shohei Shimada, Akihiro Hisada, Kyoko Hida, Yukio Hatta, Satomi Kitano, Fumihiro Uno, Miyuki Matsukawa, Haruka Noriki, Sakon Iwasaki, Hiromichi Naiki, Hironobu |
author_facet | Inai, Kunihiro Higuchi, Shohei Shimada, Akihiro Hisada, Kyoko Hida, Yukio Hatta, Satomi Kitano, Fumihiro Uno, Miyuki Matsukawa, Haruka Noriki, Sakon Iwasaki, Hiromichi Naiki, Hironobu |
author_sort | Inai, Kunihiro |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-10314941 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-103149412023-07-03 Exploration of sepsis assisting parameters in hospital autopsied-patients: a prospective study Inai, Kunihiro Higuchi, Shohei Shimada, Akihiro Hisada, Kyoko Hida, Yukio Hatta, Satomi Kitano, Fumihiro Uno, Miyuki Matsukawa, Haruka Noriki, Sakon Iwasaki, Hiromichi Naiki, Hironobu Sci Rep Article 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. Nature Publishing Group UK 2023-07-01 /pmc/articles/PMC10314941/ /pubmed/37393368 http://dx.doi.org/10.1038/s41598-023-37752-3 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Inai, Kunihiro Higuchi, Shohei Shimada, Akihiro Hisada, Kyoko Hida, Yukio Hatta, Satomi Kitano, Fumihiro Uno, Miyuki Matsukawa, Haruka Noriki, Sakon Iwasaki, Hiromichi Naiki, Hironobu Exploration of sepsis assisting parameters in hospital autopsied-patients: a prospective study |
title | Exploration of sepsis assisting parameters in hospital autopsied-patients: a prospective study |
title_full | Exploration of sepsis assisting parameters in hospital autopsied-patients: a prospective study |
title_fullStr | Exploration of sepsis assisting parameters in hospital autopsied-patients: a prospective study |
title_full_unstemmed | Exploration of sepsis assisting parameters in hospital autopsied-patients: a prospective study |
title_short | Exploration of sepsis assisting parameters in hospital autopsied-patients: a prospective study |
title_sort | exploration of sepsis assisting parameters in hospital autopsied-patients: a prospective study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314941/ https://www.ncbi.nlm.nih.gov/pubmed/37393368 http://dx.doi.org/10.1038/s41598-023-37752-3 |
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