RT Journal Article
SR Electronic
T1 Elevated plasma EPCR levels early post ICU admission predict sepsis development
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P1987
VO 40
IS Suppl 56
A1 Alice Vassiliou
A1 Anastasia Kotanidou
A1 Nikolaos Maniatis
A1 Zafeiria Mastora
A1 Panagiota Albani
A1 Ioanna Dimopoulou
A1 Apostolos Armaganidis
A1 Charalambos Roussos
A1 Stylianos Orfanos
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P1987.abstract
AB IntroductionThe endothelial protein C receptor (EPCR) mediates coagulation and inflammation. Early rise of circulating soluble (s)EPCR levels has been shown to correlate with poor outcome in critically-ill patients with severe sepsis (Guitton et al. Intensive Care Med 2011; 37: 950-6); yet potential associations of sEPCR measured early post ICU admission with subsequent sepsis development are still unknown.Aims To investigate if sEPCR plasma levels of critically-ill subjects at ICU admission predict sepsis development.Methods59 critically-ill patients suffering from medical, surgical and trauma-related pathologies were included in the study. Circulating sEPCR levels were measured ≤24h post ICU admission; all patients were free of sepsis. Demographics, APACHE II & SOFA scores were recorded and circulating PCT & CRP were measured.ResultsFrom the initial cohort, 30 patients subsequently developed sepsis and 29 did not. SOFA score (mean±SD: 6.4±2.7) and sEPCR levels (median & IQR: 173.4 (104.5-223.5) ng/mL) were significantly higher in the subsequent sepsis group as compared to the non sepsis group (5±2.3, p=0.037, and 98.3 (69.8-147.7) p=0.004, respectively). ICU mortality and PCT tended to be higher in the sepsis group. Cox regression analysis identified sEPCR as the only parameter related to sepsis development with time (RR: 1.078 & 95% CI: 1.016-1.144, by 10 sEPCR units, p=0.013). When the whole cohort was dichotomized above (≥139.5) and below the sEPCR median (<139.5), the probability of developing sepsis with time was significantly elevated in the high sEPCR group (Log-Rank test, p=0.028).ConclusionsIn our cohort, high sEPCR plasma levels at ICU admission (i.e. ≤24h) predict sepsis development.