Role of international normalized ratio in nonpulmonary sepsis screening: An observational study

Table 1 Population and baseline characteristics

	Sepsis	Nonsepsis	P value
Sex, n (%)			0.083
Male	52 (48.1)	59 (55.7)
Female	56 (51.9)	47 (44.3)
Age, yr (mean ± SD)	55 ± 9	52 ± 15	0.12
Body mass index (mean ± SD)	24.1 ± 2.2	23.8 ± 2.5	0.25
Site of infection, n (%)			0.832
Abdominal	50 (46.3)	47 (44.3)
Urinary	36 (33.3)	35 (33.0)
Skin and others	14 (13.0)	18 (17.0)
Multiple sites	8 (7.4)	6 (5.7)

SD: Standard deviation.

Table 2 Comparison of the international normalized ratio, white blood cell, neutrophil-lymphocyte count ratio, platelet, prothrombin time, activated partial thromboplastin time, Sequential “Sepsis-related” Organ Failure Assessment scores, quick Sequential “Sepsis-related” Organ Failure Assessment scores and Acute Physiology and Chronic Health Evaluation II scores between the sepsis and nonsepsis groups

	Sepsis	Nonsepsis	P value
WBC (× 109/L)	12.90 ± 8.76	9.88 ± 5.09	0.022
NLCR	28.45 ± 21.05	10.44 ± 11.87	< 0.001
INR	1.49 ± 0.47	1.11 ± 0.15	< 0.001
PLT (× 109/L)	135.09 ± 92.35	229.5 ± 72.83	< 0.001
PT (s)	17.42 ± 4.76	13.86 ± 1.75	< 0.001
APTT (s)	46.06 ± 10.30	36.88 ± 12.11	< 0.001
SOFA	6.93 ± 2.69	0.72 ± 0.45	< 0.001
qSOFA	1.17 ± 0.66	0.79 ± 0.75	0.003
APACHE Ⅱ	18.81 ± 6.90	9.29 ± 4.14	< 0.001

Data are presented as mean ± SD. APACHE II: Acute Physiological and Chronic Health Score II; APTT: Activated partial thromboplastin time; INR: International normalized ratio; NLCR: Neutrophil-lymphocyte count ratio; PLT: Platelet; PT: Prothrombin time; qSOFA: Quick Sequential “Sepsis-related” Organ Failure Assessment; SD: Standard deviation; SOFA: Sequential “Sepsis-related” Organ Failure Assessment; WBC: White blood cell.

Table 3 Analysis of influencing factors for the diagnosis of sepsis

	Univariate		Multivariate
	OR (95%CI)	P value	OR (95%CI)	P value
WBC (× 109/L)	1.066 (1.007-1.128)	0.029	0.875 (0.772-0.992)	0.037
NLCR	1.092 (1.051-1.135)	< 0.001	1.145 (1.069-1.226)	< 0.001
INR	35.214 (12.887-96.223)	< 0.001	27.106 (5.038-145.825)	< 0.001
PLT (× 109/L)	0.985 (0.980-0.991)	< 0.001	0.981 (0.97-0.991)	< 0.001
PT (s)	1.868 (1.458-2.393)	< 0.001	1.475 (1.032-2.106)	0.033
APTT (s)	1.091 (1.045-1.139)	< 0.001		0.190
qSOFA	2.122 (1.265-3.559)	0.004		0.907

APTT: Activated partial thromboplastin time; CI: Confidence intervals; INR: International normalized ratio; NLCR: Neutrophil-lymphocyte count ratio; OR: Odds ratio; PLT: Platelet; PT: Prothrombin time; qSOFA: Quick Sequential “Sepsis-related” Organ Failure Assessment; WBC: White blood cell.

Table 4 Performance characteristics of the single biomarker for diagnosing sepsis

	AUC (95%CI)	Cut-off value	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)
WBC (× 109/L)	0.599 (0.508-0.684)	11.29	48.57	72.41	68	53.8
NLCR	0.83 (0.754-0.891)	11.86	81.43	77.59	81.4	77.6
INR (× 109/L)	0.918 (0.857-0.959)	1.22	90	84.48	87.5	87.5
PLT	0.841 (0.766-0.9)	180	80	82.76	84.8	77.4
PT (s)	0.868 (0.796-0.921)	15.3	80	87.93	88.9	78.5
qSOFA ≥ 2	0.638 (0.548-0.721)		28.57	79.31	62.5	47.9

AUC: Area under curves; INR: International normalized ratio; NLCR: Neutrophil-lymphocyte count ratio; NPV: Negative predictive value; PLT: Platelet; PT: Prothrombin time; PPV: Predictive positive value; qSOFA: Quick Sequential “Sepsis-related” Organ Failure Assessment; WBC: White blood cell; 95%CI: 95% confidence intervals.