Use of blood urea nitrogen, creatinine, interleukin-6, granulocyte-macrophage colony stimulating factor in combination to predict the severity and outcome of abdominal sepsis in rats

Accurate and timely diagnosis and prognosis of sepsis remain challenging. A combination of markers, as opposed to single ones, may improve the prognosis, and therefore survival. This study compared the effectiveness of routinely used biomarkers of sepsis alone and in combination for the prediction of outcome in rats with abdominal sepsis. Rats were subjected to sepsis induced by cecal ligation and puncture (CLP). Seventeen biomarkers were detected 12 h after the CLP. Correlation between the biomarkers and outcome of rats was analyzed; the correlated biomarkers were analyzed by logistic regression analysis and the area under the receiver operating characteristic (ROC) curve was computed to compare their performance in the prognosis of sepsis. A total of 49 rats were eligible for analysis. Body temperature (T), blood urea nitrogen (BUN), creatinine (Cr), alanine aminotransferase (ALT), creatine kinase (CK), interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1) levels after the CLP were negatively correlated with the survival outcome, while platelet count (PLT), high-mobility group box protein 1 (HMGB1) and granulocyte-macrophage colony stimulating factor (GM-CCF) were positively correlated with the survival outcome (P < 0.05). Levels of BUN, Cr, IL-6, and GM-CSF after the CLP were independent predictors of outcome according to conditional logistic regression. The sensitivity and specificity of the four selected biomarkers in combination for predicting sepsis outcome were better than single ones (P < 0.05). A combination of different biomarkers improves the diagnostic accuracy and is more effective in the prognosis of sepsis in rats. Use of BUN, Cr, IL-6, GM-CSF in combination to predict the severity and outcome in rats with abdominal sepsis exhibited acceptable diagnostic characteristics.