DOI: 10.5061/dryad.n02v6wx3d
title: Data from: The interest of inflammatory biomarkers in the diagnostic approach

description: Background: The role of inflammatory biomarkers in the etiological
 orientation is increasingly under study, and their potential significance
 is recognized. Methods: Procalcitonin (PCT), neutrophil-lymphocyte ratio
 (NLR), C-reactive-protein (CRP), fibrinogen, ferritinaemia and lactate
 were measured on admission in all patients. The optimal cut-off values for
 the sensitivities and specificities to the infectious diseases were
 determined using the receiver operating curve(ROC) analysis and
 Youden's index. The diagnostic accuracy of biomarkers and their
 combinations for predicting infectious etiologies was calculated by area
 under the curve(AUC). Results: A total of 164 patients were included in
 the study. The mean age was 50.7 ± 18 years [18 – 92 years]. Fifty-three
 patients (32.3%) were over 65 years old. Patients were split into four
 groups: 53 patients (32.3%) with infectious diseases of which 45 patients
 (84.9%) presented bacterial infections, 62 patients (37.8%) with
 inflammatory diseases, 14 patients (8.5%) with neoplasms and 35 patients
 (21.3%) with other diagnosis. The high mean levels of Leukocytes (12047
 cells/mm3, Neutrophils (9015 cells/mm3), Neutrophils to lymphocytes ratio
 (NLR) (9.7), C reactive protein (CRP) (152.5 mg/L), Procalcitonin
 (PCT)(3.28 ng/ml)and fibrinogen (5.37g/L) were associated to infectious
 etiologies with statistically significant differences. Thus, we identified
 cut-offs of NLR(6.1), CRP (123 mg/L),PCT(0.24 ng/mL) and fibrinogen (4.9
 g/L) to discriminate infectious etiologies in our population. For
 diagnosing infectious diseases, the CRP showed higher AUC( Area under the
 curve) (Sp: 89.7%, Se: 64.3%, AUC=0.9, CI: 0.83-0.96, p&lt;10-3) than
 PCT (Sp: 86.1%,Se: 62.3%, AUC=0,87, CI:0.80-0.93, p&lt;10-3), NLR (Sp:
 87.1%, Se: 61%, AUC=0.81, CI: 0.731- 0.902, p &lt;10-3) and Fibrinogen
 (Sp: 84.7%, Se:68.3%, AUC=0.77, CI: 0.65 – 0.98, p&lt;10-3).The
 combination of CRP and NLR levels improved the diagnostic accuracy (AUC
 0.93, 95% CI 0.84–0.96; p&lt; 10-3) for distinguishing between
 infectious and non-infectious diseases. Conclusions: Our study is
 characterized by the variety of included disease categories. It showed the
 usefulness of inflammatory biomarkers, particularly the NLR and its
 combination with CRP, which are low cost and easy to assess, in promoting
 the diagnostic accuracy to distinguish infections among inflammatory,
 neoplasia and other diagnoses.
description: Procalcitonin (PCT), neutrophil-lymphocyte ratio (NLR),
 C-reactive-protein (CRP), fibrinogen, ferritinaemia and lactate were
 measured on admission in all patients. The optimal cut-off values for the
 sensitivities and specificities to the infectious diseases were determined
 using the receiver operating curve(ROC) analysis and Youden's index.
 The diagnostic accuracy of biomarkers and their combinations for
 predicting infectious etiologies was calculated by area under the
 curve(AUC).
description: # The interest of inflammatory biomarkers in the diagnostic approach: A
 prospective cohort study The role of inflammatory biomarkers in the
 etiological orientation is increasingly under study, and their potential
 significance is recognized. The role of inflammatory biomarkers in the
 etiological orientation is increasingly under study, and their potential
 significance is recognized. We conducted a prospective descriptive and
 analytical study about the etiological profile of inflammatory biomarkers
 measured on admission to distinguish infectious diseases, inflammatory
 diseases and neoplasia. ### Data collection: The following data were
 collected from hospitalized patients: epidemiological details, history of
 comorbidities, clinical presentation, the final diagnosis, and
 inflammatory biomarkers. These biomarkers were as follows: white blood
 cells (WBC) (normal range: 4000-10000 cell/mm 3), neutrophils (normal
 range: 1500-7000 cells/mm3), lymphocytes (normal range:1500-4000
 cells/mm3), NLR (normal range: 1-3), C-reactive protein (CRP)with normal
 range &lt; 5mg/L, procalcitonin (normal range&lt;0.1 ng/mL),
 fibrinogen (normal range: 2-4 g/l), lactate &lt; 2mmol/L and
 ferritinemia ( normal range in men &lt; 300 µg/L and in women &lt;
 200 µg/L). PCT positive level for infectious diseases was &gt; 0.25
 ng/ml. In the SPSS file, we made quantitative variables which are the
 inflammatory biomarkers count, then we made qualitative variable (the name
 of the variable + the word analyse) to define if the count is elevated or
 not. Elderly subjects were defined as those aged 65 and over Missing data:
 The empty cells mean that we didn't get the result of the
 inflammatory biomarker. ### Statistical analysis: Statistical analysis was
 performed using the Statistical Package for Social Sciences (SPSS®),
 version: 26.0.for Windows. Qualitative variables were described by their
 frequencies and percentages and quantitative variables by their means and
 standard deviation when the distribution was Gaussian and the median and
 the interquartile range [25th percentile - 75th percentile] otherwise. For
 the association of categorical variables, the Chi-square test was used.
 Student's T test for independent samples was used to compare means.
 We considered a p&lt;0.05 as statistically significant. The optimal
 cut-off values for the sensitivities and specificities to the infectious
 diseases of the NLR, CRP and PCT, were determined using the receiver
 operating curve (ROC) analysis and Youden's index. The diagnostic
 accuracy of biomarkers and their combinations for predicting infectious
 etiologies was calculated by area under the curve (AUC). Patients were
 assigned into 4 groups: Group 1 (G1): infectious diseases, Group 2 (G2):
 inflammatory diseases (connective tissue diseases, vasculitis,
 granulomatosis...), Group 3 (G3): Neoplasia, and Group 4 (G4): other
 diseases. The non-infectious etiologies combined inflammatory diseases,
 neoplasia and other diagnoses. We carried out a comparative study of
 inflammatory biomarkers among the four categories, compared their mean
 levels among infectious and non-infectious diseases, and determined their
 cut-offs to discriminate infectious diseases.