Figure 2 ROC-curves of various parameters. Enzastaurin Phase 3 Table 3 Discriminatory capacities of parameters for infection. Table 4 Performance measures of the IPS and sepsis biomarkers with statistical significance. Among the biomarkers evaluated in the present study, the best parameter was LBP with a median level of 26.2 pg/ml in patients with infections and a median level of 19.1 pg/ml in those without infections. Thus, LBP was significantly higher in SIRS patients with infection when compared with the LPS of SIRS patients without infection (p = 0.001). Although the ROC-AUC was in a moderate range (0.63), it was significantly higher compared to the ROC-AUC of the IPS (DeLong test, p = 0.043). Using a cut-off value of 24.35 pg/ml (Youden-index method), LBP demonstrated 57.5% sensitivity, 67.1% specificity, 36.

8% NPV, and 82.6% PPV. Concerning the other sepsis biomarkers evaluated, no significant differences were observed after correcting for errors related to multiple testing. Prediction of bacteremia Regarding the utility of the IPS to predict bacteremia (n=75, 25%) in patients with SIRS, no differences were observed between the IPS values among patients with bacteremia when compared to those patients with negative blood culture results. Details are presented in tables 4 and and5.5. The ROC-AUC of the IPS was 0.58 (see figure 2B), the sensitivity and specificity were 21.3% and 65.0% respectively, with 71.1% NPV and 17.0% PPV. Among the individual parameters of the IPS, significant differences were found for bilirubin (forming the SOFA score for the IPS) as well as for body temperature.

Bacteremic patients had significantly increased serum levels of bilirubin (0.82 mg/dl) when compared with SIRS patients without bacteremia (0.64 mg/dl, p <0.0001), with a ROC-AUC of 0.65. Using a cut-off value of 0.61 mg/dl, bilirubin resulted in 79.7% sensitivity, 46.2% specificity, 87.3% NPV, and 33.0% PPV. Moreover, patients with bacteremia had increased body temperature compared to non-bacteremic SIRS patients (38.5��C vs. 38.4��C, p = 0.004), with a ROC-AUC of 0.61. Using 38.6��C as a cut-off value, the assessed sensitivity was 48.0% with 72.2% specificity, 80.5% NPV, and 36.7% PPV. Table 5 Discriminatory capacities of parameters for bacteremia. Among the biomarkers evaluated, PCT was the best discriminator between SIRS patients with and without bacteremia.

The median PCT value among patients with bacteremia was 2.5 ng/ml and thus significantly higher Drug_discovery in comparison with a median of 0.3 ng/ml found in patients without bacteremia (p <0.0001). The ROC-AUC was 0.78, which was found to be superior compared to other assessed biomarkers. For ROC-AUC comparison between PCT and other assessed parameters, the DeLong test was applied, resulting in a p-value range between <0.001 and 0.0085. A cut-off value of 0.35 ng/ml was computed, resulting in 86.3% sensitivity, 59.6% specificity, 92.