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2017 ; 7
(1
): 27
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Multi-marker approach using procalcitonin, presepsin, galectin-3, and soluble
suppression of tumorigenicity 2 for the prediction of mortality in sepsis
#MMPMID28271449
Kim H
; Hur M
; Moon HW
; Yun YM
; Di Somma S
Ann Intensive Care
2017[Dec]; 7
(1
): 27
PMID28271449
show ga
BACKGROUND: Biomarker could be objective and reliable tools to predict mortality
in sepsis. We explored the prognostic utilities of emerging biomarkers in septic
patients and questioned whether adding biomarkers to the clinical variables would
improve the prediction of mortality in sepsis. METHODS: This retrospective study
included 157 septic patients (112 patients with sepsis; 45 patients with septic
shock). Procalcitonin (PCT), presepsin, galectin-3, and soluble suppression of
tumorigenicity 2 (sST2) concentrations were analyzed in relation to the 30-day
all-cause mortality. Their value added on top of Sequential (Sepsis-related)
Organ Failure Assessment (SOFA) score, high-sensitivity C-reactive protein, and
white blood cells was also analyzed. RESULTS: PCT could not predict 30-day
mortality. Univariate hazard ratio [HR with 95% confidence interval (CI)] of the
other dichotomized variables was: 1.33 (0.55-3.194) for presepsin; 7.87
(2.29-26.96) for galectin-3; 1.55 (0.71-3.38) for sST2; and 2.18 (1.01-4.75) for
SOFA score. The risk of 30-day mortality increased stepwise as the number of
biomarkers above optimal cutoff values increased, and the highest risk was
observed when all four biomarkers and SOFA score increased (HR = 14.5).
Multi-marker approach predicted 30-day mortality better than SOFA score [area
under the curves (95% CI), 0.769 (0.695-0.833) vs. 0.615 (0.535-0.692)]. In
reclassification analyses, adding biomarkers to clinical variables improved the
prediction of mortality. CONCLUSION: This study demonstrated a possible
prognostic utility of PCT, presepsin, galectin-3, and sST2 in sepsis.
Multi-marker approach could be beneficial for an optimized management of patients
with sepsis.