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Table 1 Candidate parameters for improved diagnostic and prognostic patient assessment

From: Optimizing triage and hospitalization in adult general medical emergency patients: the triage project

Candidate parameters Pathophysiological concept / Previous research findings Ref.
Infection marker (PCT) CALC I-gene associated hormokine of bacterial infections; correlates with infection severity and risk for bacteremia; responsive over time; established for antibiotic stewardship in respiratory tract infections and sepsis; moderate prognostic accuracy [3846]
Inflammatory markers (CRP, WBC) Increase in response to inflammation and infection; low specificity and moderate sensitivity; low prognostic accuracy [4749]
Organ dysfunction markers (Lactate, coagulation, liver) For progression of sepsis to severe sepsis with organ dysfunction; lactate is the recommended biomarker for early goal directed resuscitation therapy [5052]
Endothelial activation markers (VCAM-1, ICAM-1, E-selectin, PAI-1, sFLT-1, ET-1) Marker panel correlates with vascular dysfunction, with sepsis severity and sepsis-related mortality; highest markers in septic shock; marker are dynamic over time and drop when patients condition is improving [51, 5358]
Vasodilation / infection markers (Pro-adrenomedullin) CALC V-Gene associated hormokine with high prognostic accuracy in pneumonia and sepsis in the ICU setting; significantly improves pneumonia risk scores (PSI, CURB65) based on OPTIMA II study [17, 18]
Stress markers (vasopressin precursor [copeptin], cortisol) High prognostic accuracy in respiratory infections and sepsis; significantly improve previous pneumonia risk scores (PSI, CURB65) [18, 59, 60]
Cardiac dysfunction markers (Natriuretic peptides: BNP, ) Correlate with cardiac dysfunction / cardiovascular stress; moderate to high prognostic accuracy [61, 62]
Kidney dysfunction (Urea, creatinine, NGAL) High correlation with kidney dysfunction and increase in (pre) shock; also correlate with (septic) kidney injury [63]
Blood cells (red cell distribution width) Measure of variability of red cells; associated with in-hospital and ICU mortality [6466]
Nutrition (Albumin, pre- albumin, vitamin D) Markers of nutrition have been shown to correlate with the general condition of patients and the risk of needing nursing care. [67]