RT Journal Article
SR Electronic
T1 Determining the best diagnostic biomarker for sepsis and prognosis assessment
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P1986
VO 40
IS Suppl 56
A1 Longxiang Su
A1 Lixin Xie
A1 Lin Feng
A1 Qing Song
A1 Hongjun Kang
A1 Xingang Zhang
A1 Zhixin Liang
A1 Yanhong Jia
A1 Dan Feng
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P1986.abstract
AB Introduction: Current clinical practice lacks reliable diagnostic indicators for sepsis and its prognosis. Objectives: To describe the value of sTREM-1,sCD163,PCT,CRP,WBC and SOFA score during the course of sepsis, as well as their value in prognosis. Methods:130 subjects were picked out of 377 inpatients hospitalized at the RICU,SICU,and EICU. In light of Sepsis Guideline and 28-day survival, the 130 patients were divided into different subgroup. ELISA was applied, and test results were recorded on day 1,3,5,7,10,and 14. Results: On ICU admission day, the sepsis group display higher levels of sTREM-1,sCD163,PCT,and CRP than the SIRS group[180.92 (150.44) pg/ml vs. 29.41(20.77) pg/ml;2.22 (2.36) mg/dL vs. 0.88 (0.23) mg/dL;1.65 (10.1) ng/ml vs. 0.35 (1.58) ng/ml;11.76±8.09 mg/dl vs. 5.65±4.27mg/dl, P<0.05]. Although PCT,sTREM-1 and SOFA are good markers to identify the severity, sTREM-1 is more reliable. It proves to be a risk factor related to sepsis(OR=1.089,95%CI,1.045–1.136); its area under the ROC curve, meant for diagnosis, turns out 0.978(95%CI,0.958–0.997), and that for severity,0.9 (95%CI,0.823–0.977). For 14-day observation,sCD163,sTREM-1,PCT and SOFA continue to climb among non-survivors, while WBC and CRP go down. Both sCD163 and SOFA are risk factors impacting the survival time (HR=1.09,95%CI 1.035–1.154;HR=1.23, 95%CI 1.126–1.335). Their areas under the ROC curve, denoting prognosis, measures 0.696(95%CI,0.593-0.799)and 0.794(95%CI,0.705–0.833) respectively. Conclusion: With regard to sepsis diagnosis and severity, sTREM-1 is more ideal, and constitutes an risk factor. sCD163 and SOFA are of positive value in dynamic prognostic assessment, and may be taken as survival-impacting risk factors.