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Background: The prediction of infection and its severity remains difficult in the critically ill. A novel, simple biomarker derived from five blood-cell derived parameters that characterize the innate immune response in routine blood samples, the intensive care infection score (ICIS), could be helpful in this respect. We therefore compared the predictive value of the ICIS with that of the white blood cell count (WBC), C-reactive protein (CRP) and procalcitonin (PCT) for infection and its severity in critically ill patients. Methods: We performed a multicenter, cluster-randomized, crossover study in critically ill patients between January 2013 and September 2014. Patients with a suspected infection for which blood cultures were taken by the attending intensivist were included. Blood was taken at the same time for WBC, ICIS, CRP and PCT measurements in the control study periods. Results of imaging and cultures were collected. Patients were divided into groups of increasing likelihood of infection and invasiveness: group 1 without infection or with possible infection irrespective of cultures, group 2 with probable or microbiologically proven local infection without blood stream infection (BSI) and group 3 with BSI irrespective of local infection. Septic shock was assessed. Results: In total, 301 patients were enrolled. CRP, PCT and ICIS were higher in groups 2 and 3 than group 1. The area under the receiver operating characteristic curve (AUROC) for the prediction of infection was 0.70 for CRP, 0.71 for PCT and 0.73 for ICIS (P < 0.001). For the prediction of septic shock the AUROC was 0.73 for CRP, 0.85 for PCT and 0.76 for ICIS. These AUROC did not differ from

This book presents an overview of the diversity and richness of ongoing and recent sustainable development research at ICIS (international Centre for Integrated assessment and Sustainable development, Maastricht University) in 35 short chapters, and it introduces the research agenda for the coming years. The book is intended for a broad audience of fellow researchers, collaborators from outside academia, students, and in fact everyone who is interested in learning more about the topics and types of research conducted at ICIS. ICIS is Maastricht University’s scientific institute for sustainable development. ICIS vision is that research, education and joint learning provides a knowledge base for policymaking and innovation in pursuit of sustainability. An important feature of ICIS research is its contribution to sustainability assessment. ICIS contributes to the scientific debate about sustainable development, but also tries to achieve a constructive social impact towards sustainability in practice. www.maastrichtuniversity.nl/icis

This book presents an overview of the diversity and richness of ongoing and recent sustainable development research at ICIS (international Centre for Integrated assessment and Sustainable development, Maastricht University) in 35 short chapters, and it introduces the research agenda for the coming years. The book is intended for a broad audience of fellow researchers, collaborators from outside academia, students, and in fact everyone who is interested in learning more about the topics and types of research conducted at ICIS. ICIS is Maastricht University’s scientific institute for sustainable development. ICIS vision is that research, education and joint learning provides a knowledge base for policymaking and innovation in pursuit of sustainability. An important feature of ICIS research is its contribution to sustainability assessment. ICIS contributes to the scientific debate about sustainable development, but also tries to achieve a constructive social impact towards sustainability in practice. www.maastrichtuniversity.nl/icis