Univariate analysis identified six factors relative to sepsis diagnosis on ICU admission (Table selleckbio (Table3).3). In order to screen whether the presence of at least two variables will perform better than a single recommended gold standard parameter (that is, sepsis score or PCT) to predict sepsis on admission, two new combinations of at least two out of three variables have been created. One of these was performant if at least two out of the three categorized variables were positive (that is .ACTH �� 233 nMol/L, cortisol baseline �� 450 nMol/L or PCT > 2 ng/mL), with an OR much higher than PCT alone (Table (Table3)3) and an AUC of 0.845 (0.738 to 0.920, 95% CI) vs. 0.726 (0.607 to 0.826, 95% CI) (P = 0.035). The other one (that is, ACTH �� 233 nMol/L, cortisol baseline �� 450 nMol/L or sepsis score >7) was also performant (Table (Table3)3) but AUCs were similar (0.

811 (0.700 to 0.895, 95% CI) vs. 0.727 (0.607 to 0.827, 95% CI), P = 0.076).Table 3Prediction of sepsis diagnosis on admission: univariate regression analyse* (n = 74 patients)Different multivariate logistic regression with stepwise method were performed to identify which of the significant variables in the univariate analyse perform better to assess sepsis diagnosis on admission (Table (Table4).4). ROC analysis was used to represent the probability score predicting early sepsis diagnosis from equations and to compare different models of regression. A first model was performed with categorized sepsis score, and PCT as well as shock were excluded because already part of its calculation.

Another model was constructed by substituting sepsis score by PCT. These two models (M1 and 2) performed similarly (Table (Table4,4, P = 0.494) but were more efficient than the model (M3) including only categorized ACTH and cortisol baseline (P = 0.036 and = 0.0037, respectively). The best AUCs are shown in Figure Figure88.Table 4Different models of logistic regression to predict sepsis diagnosis on admission * (n = 74 patients)Figure 8Comparative Receiver operating characteristic curves for early sepsis diagnosis. The curves relate the different models of logistic regression detailed in Table 4: M1: sepsis score >7; ACTH �� 233 nM/L; cortisol �� 450 nM/L, M2: …DiscussionThe present study highlights differentially AV-951 profiled stress responses consecutive to ICU admission between septic and non-septic patients. Septic patients exhibited higher cortisol baseline but decreased blood ACTH-to-cortisol ratio, and higher SDF-1��, copeptin, and apelin on admission. Copeptin, cortisol baseline and ACTH on admission were higher in septic non-survivors, while SDF-1�� as well as AVP, in non-septic patients, was correlated with cortisol baseline.