title: Predictors of survival in sepsis:  what is the best inflammatory marker to measure?
abstract: OBJECTIVE
  Sepsis is relevant due to its high morbidity and mortality. For both sepsis diagnosis and outcome prediction many biomarkers have been described in the literature. Most of these markers are objects of scientific interest rather than being introduced into daily clinical practice. However, due to their unspecific character and their insufficient predictive value for the individual person, research focus is still on new aspects in sepsis-related biomarkers.
  
  
  RESULTS
  Beyond the widely used acute-phase proteins C-reactive protein (CRP) and procalcitonin (PCT), many new molecules have been studied deriving from different organs or cells affected, due to the systemic nature of sepsis. Cytokines, coagulation factors/characteristics, vasoactive hormones, and several others have been recently proved to be relevant in sepsis syndrome and probably useful for outcome prediction. However, single time point measurements may be less predictive than consideration of the time-dependent course of parameters. Clinical decision just based on a biomarker is still not feasible because of the huge inter-individual differences in the inflammatory response.
  
  
  CONCLUSIONS
  Many biomarkers display relevant correlation with the clinical outcome of patients with severe sepsis and septic shock. Consideration of their time courses may be more reliable than absolute levels. Clinical decision should not be based only on biomarkers but organ dysfunctions, for example, should also be taken into account.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital of Giessen and Marburg, Giessen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Lichtenstern
authors.forename: Thorsten
authors.initials: T
authors.lastname: Brenner
authors.forename: Hubert J
authors.initials: HJ
authors.lastname: Bardenheuer
authors.forename: Markus A
authors.initials: MA
authors.lastname: Weigand
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis; D015415:Biomarkers / Q000032:analysis*; D016207:Cytokines / Q000032:analysis; D006801:Humans; D036361:Peptide Hormones / Q000032:analysis; D011237:Predictive Value of Tests; D018805:Sepsis / Q000175:diagnosis*; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis; D014336:Troponin / Q000032:analysis
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D016207:Cytokines; D036361:Peptide Hormones; D014336:Troponin