| Test | Cut-off | No. of studies (episodes) | Proportion with outcome (range) | Sensitivity (95% C.I.) | Specificity (95% C.I.) | LR+ (range) | LR- (range) | Analysis method for Sn and Sp | References |
|---|---|---|---|---|---|---|---|---|---|
| Mortality | |||||||||
| Lactate | 3 mmol/L | 1 (110) | 6% | 0.43 0.82] | 0.93 | 6.31 | 0.61 | Not pooled | Ramzi 2007 |
| AMC | 0.1 × 109/L | 2 (931) | 4% | Range 0.37 [0.19, to 1.00 [0.77, | Range 0.51 to 0.58 | 0.88 to 2.04 | 0 to 1.08 | Not pooled | Santolaya 2007; Tezcan 2006 |
| ANC | 0.1 × 109/L | 3 (1388) | 4% to 8% | 0.67 [0.10, 0.97] | 0.71 [0.49, 0. 86] | 0.66 to 3.18 | 0 to 1.17 | Univariate random effects model | Santolaya 2007; Tezcan 2006; Wilbur 2000 |
| CRP | 90 mg/L | 1 (373) | 4% | 0.79 | 0.62 | 2.07 | 0.34 | Not pooled | Santolaya 2007; |
| Creatinine | 17 mg/L | 1 (393) | 8% | 0.53 | 0.89 | 4.92 | 0.53 | Not pooled | Wilbur 2000 |
| BUN | 180 to 260 mg/L | 2 (764) | 4% to 8% | Range 0.43 to 0.69 | Range 0.86 to 0.94 [ | 5.04 to 7.33 | 0.36 to 0.61 | Not pooled | Santolaya 2007; Wilbur 2000 |
| Albumin | 25 g/L | 1 (268) | 10% | 0.29 | 0.88 [ | 2.36 | 0.81 | Not pooled | Wilbur 2000 |
| Platelets | 25,000/mm3 | 1 (394) | 8% | 0.44 | 0.76 | 1.82 | 0.74 | Not pooled | Wilbur 2000 |
| Severe sepsis | |||||||||
| Lactate | 2 to 3 mmol/L | 2 (340) | 13% to 20% | Range 0.26 to 0.57 | Range 0.97 to 0.98 | 8.00 to 27.43 | 0.44 to 0.76 | Not pooled | Mato 2010; Ramzi 2007 |
| CRP | 60 mg/L to 100 mg/L | 4 (829) | 20% to 58% | 0.75 [0.52, 0.89] | 0.64 [0.60, 0.67] | 1.47 to 2.31 | 0 to 0.72 | Univariate random effects model | Erten 2000; Karan 2002; Moon 2009; Santolaya 2008 |
| Creatinine | 2 to 20 mg/L | 3(1215) | 15% to 60% | 0.07 [0.03, 0.14] | 0.97 [0.80, 0.99] | 0.68 to 7.34 | 0.88 to 1.02 | Univariate random effects model | Chayakulkeeree 2003; Moon 2009; Klastersky 2000 |
| BUN | 200 mg/L | 2(459) | 26% to 60% | Range 0.27 to 0.44 | Range 0.88 to 0.93 | 2.25 to 6.25 | 0.96 to 1.02 | Not pooled | Chayakulkeeree 2003; Moon 2009 |
| Albumin | 25 to 30 mg/L | 3 (1215) | 20% to 60% | 0.11 [0.05, 0.23] | 0.95 [0.89, 0.98] | 1.91 to 2.83 | 0.89 to 0.97 | Univariate random effects model | Chayakulkeeree 2003; Klastersky 2000; Moon 2009 |
| ANC | 0.1 × 109/L | 2 (948) | 15% to 20% | Range 0.63 to 0.79 | Range 0.33 to 0.41 | 1.07 to 1.18 | 0.63 to 0.90 | Not pooled | Klastersky 2000; Moon 2009 |
| AMC | 0.1 × 109/L | 1 (192) | 20% | 0.68 | 0.57 | 1.60 | 0.55 | Not pooled | Moon 2009 |
| Platelets | 50,000/mm3 | 2 (948) | 15% to 20% | Range 0.11 to 0.53 | Range 0.83 to 0.92 | 1.45 to 3.12 | 0.57 to 0.96 | Not pooled | Klastersky 2000; Moon 2009 |
| Bilirubin | 20 mg/L | 2 (1023) | 24% to 60% | Range 0.04 to 0.18 | Range 0.96 to 0.96 | 1.05 to 4.92 | 0.85 to 1.00 | Not pooled | Chayakulkeeree 2003; Klastersky 2000; |
| Haemoglobin | 80 g/L | 2 (1023) | 15% to 60% | Range 0.18 to 0.50 | Range 0.61 to 0.86 | 1.28 | 0.82 to 0.95 | Not pooled | Chayakulkeeree 2003; Klastersky 2000; |
| WBC | 0.5 × 109/L | 1 (192) | 20% | 0.61 | 0.61 | 1.55 | 0.65 | Not pooled | Moon 2009 |
| Documented infection | |||||||||
| CRP | 5 to 20 mg/L | 6 (692) | 29% to 75% | 0.84 [0.5, 0.96] | 0.35 [0.08, 0.78] | 0.85 to 3.45 | 0.25 to 1.39 | Bivariate model | Ammann 2003; Avabratha 2009; Diepold 2008; Hitoglu-Hatzi 2005; Katz 1992; Riikonen 1993 |
| CRP | >30 to 40 mg/L | 4 (373) | 26% to 66% | 0.95 [0, 1] | 0.26 [0, 1] | 0.89 to 4.05 | 0 to 3.00 | Bivariate model | Yonemori 2001; Massaro 2007; Santolaya 1994; Manian 1995 |
| CRP | 50 mg/L | 6 (683) | 29% to 64% | 0.58 [0.13, 0.93] | 0.69 [0.57, 0.79] | 0.53 to 3.83 | 0.13 to 1.20 | Bivariate model | Ammann 2003; Hatzistilianou 2007; Hitoglu-Hatzi 2005; Katz 1992; Riikonen 1993; Secmeer 2007 |
| CRP | 90 to 100 mg/L | 6 (850) | 33% to 69% | 0.67 [0.27, 0.92] | 0.81 [0.44, 0.96] | 1.49 to 4.98 | 0.31 to 0.82 | Bivariate model | El-Maghraby 2007; Hitoglu-Hatzi 2005; Santolaya 2001; Martinez-Albarran 2009; Katz 1992; Manian 1995 |
| ANC | 0.05 to 0.1 × 109/L | 6 (2898) | 16% to 56% | 0.58 [0.35, 0.78] | 0.52 [0.26, 0.78] | 0.91 to 2.03 | 0.51 to 1.75 | Univaria te random effects model | Ha 2010; Hakim 2010; Klaassen 2000; Rondinelli 2006; Santolaya 2001; Tezcan 2006 |
| AMC | 0.1 × 109/L | 5 (1709) | 19% to 56% | 0.73 [0.29, 0.95] | 0.45 [0.10, 0.86] | 1.02 to 1.73 | 0.40 to 0/83 | Bivariate model | Ammann 2003; Rondinelli 2006; Santolaya 2001; Tezcan 2006; Klaassen 2000 |
| Haemoglobin | 70g/L | 2 (750) | 33% to 40% | Range 0.24 to 0.30 | Range 0.79 to 0.82 | 1.16 to 1.68 | 0.85 to 0.96 | Not pooled | Rondinelli 2006; Santolaya 2001 |
| Platelets | 20,000 to 75,000/mm3 | 4 (1053) | 14% to 40% | 0.59 [0.25, 0.999] | 0.63 [0.00, 0.90] | 1.20 to 1.75 | 0.49 to 0.83 | Bivariate model | Hakim 2010; Rondinelli 2006; Santolaya 2001; Klaassen 2000 |
| Creatinine | 75 mg/L | 1 (237) | 38% | Range 0.02 to 0.11 | Range 0.91 to 0.99 | 1.19 | 0.98 | Not pooled | Ammann 2003; |
Abbreviations: ANC, absolute neutrophil count; AMC, absolute monocyte count; CRP, C-reactive protein; BUN, blood urea nitrogen, Sn, sensitivity; Sp, specificity.
From: Identification and Assessment: guideline chapter four
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.