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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Serial Changes in Routine Inflammatory, Hematologic, and Renal Laboratory Markers in Adults Hospitalized with Clinically Recorded Sepsis: A Longitudinal Observational Cohort Study

  • Andra Rotea1
  • Bogdan Rotea1,2
  • Mădălina Suba3,4
  • Ovidiu Roșca3,5
  • Bogdan Cerbu1,2,6
  • Ileana Enătescu2,6
  • Mirabela Dima2,6
  • Emil Radu Iacob2,7
  • Adrian Gluhovschi8
  • Daniela Iacob2,6
8 affiliations
  1. 1Doctoral School, Victor Babeș University of Medicine and Pharmacy, 300041 Timișoara, Romania
  2. 2Center for Multidisciplinary Research and Management in Pediatric Surgical Conditions, Iosif Nemoianu Street No. 2, 300011 Timișoara, Romania
  3. 3Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, Victor Babeș University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
  4. 4Dr. Victor Babeș Clinical Hospital of Infectious Diseases and Pneumophthisiology, 300310 Timișoara, Romania
  5. 5Department XIII, Discipline of Infectious Diseases, Victor Babeș University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
  6. 6Discipline of Neonatology, Victor Babeș University of Medicine and Pharmacy, 300041 Timișoara, Romania
  7. 7Department of Pediatric Surgery and Orthopedics, Victor Babeș University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
  8. 8Department XII, Discipline of Obstetrics and Gynecology, Victor Babeș University of Medicine and Pharmacy, 300041 Timișoara, Romania
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Abstract

Background/Objectives: Serial laboratory measurements may capture within-episode changes not represented by a single baseline value, while routine markers from different biological domains may not evolve concordantly. Methods: We retrospectively analyzed 100 hospital admission episodes in which the source infection field explicitly recorded sepsis. A complete source-record re-audit confirmed sepsis wording in all 100 episodes and identified no severe-infection-only subgroup. Because complete SOFA components were unavailable, Sepsis-3 criteria were not retrospectively adjudicated. Procalcitonin (PCT), C-reactive protein (CRP), white blood cell count (WBC), platelet count, and serum creatinine were evaluated across three ordered recorded assessment points using random-intercept linear mixed-effects models, with Holm correction across five primary global tests and generalized estimating equations as robustness analyses. Results: PCT geometric means decreased from 0.925 to 0.306 ng/mL (Holm-adjusted p = 0.000052), CRP from 104.2 to 36.0 mg/L (p < 0.001), and serum creatinine from 1.49 to 1.10 mg/dL (p = 0.000074). Platelet count increased on the additive scale (p = 0.000237) but not after logarithmic transformation, whereas the full-cohort primary WBC model was non-significant (p = 0.0743). Conclusions: Routine laboratory markers showed heterogeneous cohort-level longitudinal patterns, supporting marker-specific rather than uniform interpretation of serial measurements.

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Cite

BibTeXRIS
BibTeX
@article{rotea2026serial,
  title = {{Serial Changes in Routine Inflammatory, Hematologic, and Renal Laboratory Markers in Adults Hospitalized with Clinically Recorded Sepsis: A Longitudinal Observational Cohort Study}},
  author = {Andra Rotea and Bogdan Rotea and Mădălina Suba and Ovidiu Roșca and Bogdan Cerbu and Ileana Enătescu and Mirabela Dima and Emil Radu Iacob and Adrian Gluhovschi and Daniela Iacob},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218246},
  url = {https://www.mdpi.com/2077-0383/15/21/8246},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Serial Changes in Routine Inflammatory, Hematologic, and Renal Laboratory Markers in Adults Hospitalized with Clinically Recorded Sepsis: A Longitudinal Observational Cohort Study
AU  - Andra Rotea
AU  - Bogdan Rotea
AU  - Mădălina Suba
AU  - Ovidiu Roșca
AU  - Bogdan Cerbu
AU  - Ileana Enătescu
AU  - Mirabela Dima
AU  - Emil Radu Iacob
AU  - Adrian Gluhovschi
AU  - Daniela Iacob
PY  - 2026
DA  - 2026/10/23
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218246
UR  - https://www.mdpi.com/2077-0383/15/21/8246
AB  - Background/Objectives: Serial laboratory measurements may capture within-episode changes not represented by a single baseline value, while routine markers from different biological domains may not evolve concordantly. Methods: We retrospectively analyzed 100 hospital admission episodes in which the source infection field explicitly recorded sepsis. A complete source-record re-audit confirmed sepsis wording in all 100 episodes and identified no severe-infection-only subgroup. Because complete SOFA components were unavailable, Sepsis-3 criteria were not retrospectively adjudicated. Procalcitonin (PCT), C-reactive protein (CRP), white blood cell count (WBC), platelet count, and serum creatinine were evaluated across three ordered recorded assessment points using random-intercept linear mixed-effects models, with Holm correction across five primary global tests and generalized estimating equations as robustness analyses. Results: PCT geometric means decreased from 0.925 to 0.306 ng/mL (Holm-adjusted p = 0.000052), CRP from 104.2 to 36.0 mg/L (p < 0.001), and serum creatinine from 1.49 to 1.10 mg/dL (p = 0.000074). Platelet count increased on the additive scale (p = 0.000237) but not after logarithmic transformation, whereas the full-cohort primary WBC model was non-significant (p = 0.0743). Conclusions: Routine laboratory markers showed heterogeneous cohort-level longitudinal patterns, supporting marker-specific rather than uniform interpretation of serial measurements.
SN  - 2077-0383
ER  -