RT Journal Article
SR Electronic
T1 Serum bilirubin/fetuin-A ratio in critically ill septic patients: a prospective study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2750
DO 10.1183/13993003.congress-2020.2750
VO 56
IS suppl 64
A1 Karampela, Irene
A1 Chrysanthopoulou, Evangelia
A1 Skyllas, George
A1 Simitsis, Panagiotis
A1 Christodoulatos, Gerasimos Socrates
A1 Kandri, Evangelia
A1 Antonakos, George
A1 Armaganidis, Apostolos
A1 Dalamaga, Maria
YR 2020
UL http://erj.ersjournals.com/content/56/suppl_64/2750.abstract
AB Aims and Objectives: Sepsis constitutes an acute inflammatory response to infection affecting liver function. Increased serum bilirubin as well as decreased fetuin-A, a major hepatokine, have been shown in critically ill patients with sepsis. We aim to explore the association of serum bilirubin/fetuin-A (B/F) ratio early in sepsis with severity and outcome.Methods: In a prospective study, serum total bilirubin and fetuin-A were determined in 90 critically ill patients (52 males, age 65±15 years, APACHE II 24 ±7, SOFA 10±3) at sepsis onset and one week after. B/F ratio was calculated using the formula 10.000 x Bilirubin (mg/dL) / Fetuin-A (μg/mL). Mortality rate at 28 days after enrollment was the primary outcome.Results: Twenty eight patients (31%) died within 28 days. Bilirubin and fetuin-A increased one week after sepsis onset compared to baseline (1.16±2.3 vs 1.38±2.84mg/dL, p=0.03 and 306±107 vs 372±147μg/mL, p<0.001, respectively) while B/F ratio did not change significantly (42.5±82.3 vs 45.5±99.7, p=0.47). B/F ratio was significantly higher and fetuin-A lower in patients presenting with septic shock (N=38) compared to sepsis (N=52) and in nonsurvivors (N=28) compared to survivors (N=62) both at enrollment and one week after, while baseline bilirubin did not significantly differ. Baseline B/F ratio was significantly associated with APACHE and SOFA. ROC curve analysis showed that baseline B/F ratio outperformed bilirubin as predictor of 28-day mortality (AUC: 0.78, 95%CI 0.69-0.88, p<0.001 and 0.69, 95%CI 0.57-0.8, p=0.003, respectively).Conclusions: B/F ratio at sepsis onset is associated with severity and outcome and may be a useful prognostic biomarker in critically ill septic patients.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 2750.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).