• John C Marshall, Debra Foster, Jean-Louis Vincent, Deborah J Cook, Jonathan Cohen, R Phillip Dellinger, Steven Opal, Edward Abraham, Stephen J Brett, Terry Smith, Sangeeta Mehta, Anastasia Derzko, Alex Romaschin, and MEDIC study.
• University Health Network, University of Toronto, Toronto, Ontario, Canada. john.marshall@uhn.on.ca
• J. Infect. Dis. 2004 Aug 1;190(3):527-34.

AbstractA novel assay for endotoxin, based on the ability of antigen-antibody complexes to prime neutrophils for an augmented respiratory burst response, was studied in a cohort study of 857 patients admitted to an intensive-care unit (ICU). On the day of ICU admission, 57.2% of patients had either intermediate (>or=0.40 endotoxin activity [EA] units) or high (>or=0.60 units) EA levels. Gram-negative infection was present in 1.4% of patients with low EA levels, 4.9% with intermediate levels, and 6.9% with high levels; EA had a sensitivity of 85.3% and a specificity of 44.0% for the diagnosis of gram-negative infection. Rates of severe sepsis were 4.9%, 9.2%, and 13.2%, and ICU mortality was 10.9%, 13.2%, and 16.8% for patients with low, intermediate, and high EA levels, respectively. Stepwise logistic regression analysis showed that elevated Acute Physiology and Chronic Health Evaluation II score, gram-negative infection, and emergency admission status were independent predictors of EA.

28 keywords...

hide…