Comparison of sepsis severity markers in emergency department

Abstract

Objective This study was to evaluate the values of endothelial cell-specific molecule1 (endocan),von Willebrand factor (vWF),andA disintegrin-like and metalloprotease with thrombospondin type 1 motif(ADAMTS-13), alone or in combination, in the risk stratification and disease severity assessment of patients with sepsis via comparing the differences of these markers in patients with systemic inflammatory reaction syndrome (SIRS), sepsis, severe sepsis, or septic shock, and healthy volunteers. Methods Clinical data of 301 patients with SIRS or sepsis treated in our Emergency Department from October 2014 to October 2015, were prospectively analyzed. These patients were divided into SIRS, sepsis, severe sepsis, and septic shock groups. 40 healthy individuals were selected as control. Endocan, vWF, ADAMTS-13, vWF/ADAMTS-13, and Procalcitonin (PCT) levels were measured, and APACHEⅡ score, MEDS score as well as SOFA score were calculated. The all-cause death or survival of each patient was recorded during the 28-day follow-up. Results The endocan, vWF, and vWF/ADAMTS-13 levels significantly increased in patients with SIRS, sepsis, severe sepsis, or septic shock and were positively correlated with disease severity, and were also positively correlated with MEDS score, APACHEⅡ score, SOFA score. On the other way, the ADAMTS-13 level gradually declined during disease progression and was negatively correlated with the disease severity, it was also negatively correlated with MEDS score, APACHEⅡ score, SOFA score. Conclusions Endocan, vWF, ADAMTS-13, and vWF/ADAMTS-13 ratio are valuable in the risk stratification and disease severity evaluation of sepsis, providing novel sepsis biomarkers in clinic. Key words: Endothelial cell specific molecule-1; von Willebrand factor; A disintegrin-like and metalloprotease with thrombospondin type 1 motif; Sepsis; Risk stratification