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Clinical Chemistry 50: 1301-1314, 2004. First published May 27, 2004; 10.1373/clinchem.2004.032144
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(Clinical Chemistry. 2004;50:1301-1314.)
© 2004 American Association for Clinical Chemistry, Inc.


Review

Toward Resolving the Challenges of Sepsis Diagnosis

Shawn D. Carrigan1, George Scott2 and Maryam Tabrizian1,a

1 McGill University, Biomedical Engineering Department, Montreal, QC, Canada. 2 MDS Pharma Services, St. Laurent, QC, Canada.

aAddress correspondence to this author at: McGill University, Biomedical Engineering Department, 3775 University St., Duff Medical Building, Rm. 316, Montreal, QC, Canada, H3A 2B4.

Sepsis in the United States has an estimated annual healthcare cost of $16.7 billion and leads to 120 000 deaths. Insufficient development in both medical diagnosis and treatment of sepsis has led to continued growth in reported cases of sepsis over the past two decades with little improvement in mortality statistics. Efforts over the last decade to improve diagnosis have unsuccessfully sought to identify a "magic bullet" proteic biomarker that provides high sensitivity and specificity for infectious inflammation. More recently, genetic methods have made tracking regulation of the genes responsible for these biomarkers possible, giving current research new direction in the search to understand how host immune response combats infection. Despite the breadth of research, inadequate treatment as a result of delayed diagnosis continues to affect approximately one fourth of septic patients. In this report we review past and present diagnostic methods for sepsis and their respective limitations, and discuss the requirements for more timely diagnosis as the next step in curtailing sepsis-related mortality. We also present a proposal toward revision of the current diagnostic paradigm to include real-time immune monitoring.




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