{
  "abstract": "Objective\n\nThis study aimed to investigate the diagnostic performance of a modified inflammatory burden index (mIBI) and conventional biomarkers in sepsis and septic shock and assess the clinical utility of their combined application with the PCT/LYM ratio.Methods\n\nA retrospective analysis included 45 patients with sepsis, 77 with septic shock, and 54 with non-septic infectious inflammation (control). Levels of procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), neutrophil count (NEU), and lymphocyte count (LYM) were measured. Composite indices including mIBI, PCT/LYM, CRP/LYM, and NLR were calculated. Multivariable logistic regression evaluated the independent diagnostic value of mIBI and PCT/LYM after adjusting for confounders.Results\n\nInflammatory markers and composite indices increased progressively from control to sepsis to septic shock, whereas LYM decreased (all P < 0.05). For sepsis diagnosis, PCT/LYM showed strong diagnostic performance (AUC = 0.851, 95% CI: 0.775-0.928; sensitivity 80.00%, specificity 81.48% at cutoff 0.91), followed by mIBI (AUC = 0.806, specificity 88.89%). For septic shock, PCT/LYM (AUC = 0.880) and mIBI (AUC = 0.877) were comparable to PCT and IL-6 (all AUC = 0.879). Multivariable analysis revealed that after adjustment for age, sex, qSOFA, diabetes, and renal insufficiency, both log₁₀(mIBI) (OR = 2.771, P < 0.001) and PCT/LYM (OR = 1.045, P = 0.002) were independent predictors for sepsis. For septic shock, log₁₀(mIBI) retained independent predictive capacity (OR = 1.399, P = 0.030), whereas PCT/LYM showed a borderline association (OR = 1.004, P = 0.053).Conclusion\n\nThe composite framework integrating PCT/LYM and mIBI addresses limitations of single biomarkers. PCT/LYM demonstrated independent predictive value, with a numerically higher AUC than PCT alone for both sepsis and septic shock, although the direct DeLong comparison did not reach statistical significance, supporting its potential utility as part of a composite screening approach. Modified IBI showed strong independent diagnostic value for sepsis and high univariate discriminative ability for septic shock. These routinely available indicators offer timely, cost-effective advantages for early sepsis identification and risk stratification.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Laboratory Medicine, Kaifeng Central Hospital, Kaifeng, Henan, China.",
    "Key Laboratory of Tumor Biological Marker Detection of Kaifeng, Kaifeng, Henan, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zhen-Zhen Ding"
    },
    {
      "affs": [
        1
      ],
      "name": "Qian Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Chun-Yan Ma"
    },
    {
      "affs": [
        0
      ],
      "name": "Hang Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8tkp9z9kvh9vk.bib",
  "cited_by": 0,
  "doi": "10.3389/fcimb.2026.1845721",
  "fulltext_url": "https://europepmc.org/articles/PMC13683176",
  "id": "8tkp9z9kvh9vk",
  "issns": [
    "2235-2988"
  ],
  "landing_url": "https://europepmc.org/article/MED/42908649",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Sepsis Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7220863199",
  "pdf_url": "https://europepmc.org/articles/PMC13683176?pdf=render",
  "pmcid": "PMC13683176",
  "pmid": "42908649",
  "published": "2026-10-07",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/8tkp9z9kvh9vk.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:53Z",
      "native_id": "MED:42908649",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42908649"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Sepsis Diagnosis and Treatment",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Diagnostic utility of the modified inflammatory burden index and PCT/LYM ratio for sepsis stratification and early prediction of septic shock.",
  "title_text": "Diagnostic utility of the modified inflammatory burden index and PCT/LYM ratio for sepsis stratification and early prediction of septic shock.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:53Z",
  "url": "https://research.draconitic.com/paper/8tkp9z9kvh9vk",
  "venue": "Frontiers in cellular and infection microbiology",
  "versions": []
}