{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:50:09Z","timestamp":1791352209082,"version":"4.3.1"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Inflammatory markers and composite indices increased progressively from control to sepsis to septic shock, whereas LYM decreased (all\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.05). For sepsis diagnosis, PCT\/LYM showed strong diagnostic performance (AUC\u00a0=\u00a00.851, 95% CI: 0.775\u20130.928; sensitivity 80.00%, specificity 81.48% at cutoff 0.91), followed by mIBI (AUC\u00a0=\u00a00.806, specificity 88.89%). For septic shock, PCT\/LYM (AUC\u00a0=\u00a00.880) and mIBI (AUC\u00a0=\u00a00.877) were comparable to PCT and IL-6 (all AUC\u00a0=\u00a00.879). Multivariable analysis revealed that after adjustment for age, sex, qSOFA, diabetes, and renal insufficiency, both log\n                      <jats:sub>10<\/jats:sub>\n                      (mIBI) (OR\u00a0=\u00a02.771, P &amp;lt; 0.001) and PCT\/LYM (OR\u00a0=\u00a01.045, P\u00a0=\u00a00.002) were independent predictors for sepsis. For septic shock, log\n                      <jats:sub>10<\/jats:sub>\n                      (mIBI) retained independent predictive capacity (OR\u00a0=\u00a01.399, P\u00a0=\u00a00.030), whereas PCT\/LYM showed a borderline association (OR\u00a0=\u00a01.004, P\u00a0=\u00a00.053).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1845721","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:53:05Z","timestamp":1791348785000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic utility of the modified inflammatory burden index and PCT\/LYM ratio for sepsis stratification and early prediction of septic shock"],"prefix":"10.3389","volume":"16","author":[{"given":"Zhen-Zhen","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Kaifeng Central Hospital","place":["Kaifeng, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Li","sequence":"additional","affiliation":[{"name":"Key Laboratory of Tumor Biological Marker Detection of Kaifeng","place":["Kaifeng, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Yan","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Kaifeng Central Hospital","place":["Kaifeng, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Kaifeng Central Hospital","place":["Kaifeng, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1177\/10760296251414093","article-title":"Risk factors and predictive value of interleukin-6 and lymphocyte count in sepsis-induced coagulopathy: A retrospective study","volume":"32","author":"B","year":"2026","journal-title":"Clin. 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