Abstract
Sepsis remains a critical problem with high mortality worldwide, but there is still a lack of reliable biomarkers. We aimed to evaluate the serum lysophosphatidylcholine (LPC) 16:0 as a biomarker of sepsis using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Patients admitted to intensive care unit at Severance Hospital from March 2017 through June 2018 were prospectively enrolled. The inclusion criteria were the fulfillment of at least two criteria of systemic inflammatory response syndrome (SIRS) or the presence of sepsis. Of the 127 patients, 14 had non-infectious SIRS, 41 had sepsis, and 72 had septic shock. The mean serum LPC 16:0 concentration (µmol/L) in non-infectious SIRS was significantly higher than in patients with sepsis and septic shock (101.1 vs. 48.92, p < 0.05; 101.1 vs. 25.88, p < 0.001, respectively). The area under the curve (AUC) predicting 28-day mortality using ΔLPC16:0 (D1-D0) levels was 0.7, which was comparable with the APACHE II score (AUC 0.692) and SOFA score (AUC 0.67). Mechanical ventilation, CRRT, lactate, Δ LPC16:0 (D1-D0) less than the cut-off value were significantly associated with 28-day mortality in multivariable analysis. Our results suggest that LPC16:0 could be a useful biomarker for sepsis diagnosis and mortality prediction in ICU patients.
Highlights
Sepsis remains a critical problem with high mortality worldwide, but there is still a lack of reliable biomarkers
Urinary tract infections were more common in survivors (19.2% vs. 2.5%, p = 0.018), while the proportion of abdominal infections was significantly higher in non-survivors (11.0% vs. 32.5%, p = 0.006)
We found that the changes in LPC16:0 concentration over time were closely associated with 28-day mortality in sepsis patients under intensive care
Summary
Sepsis remains a critical problem with high mortality worldwide, but there is still a lack of reliable biomarkers. Recent evidence suggests that cell surface markers associated with immune d ysfunction[7,8] and a peripheral blood-based molecular assay, designated as “SeptiCyte LAB,” could be promising for discriminating sepsis from non-infectious systemic inflammation[9,10]. These approaches may require considerable time, effort, and cost. The aim of this present study was to confirm our previous identified LPC 16:0 associated with clinical outcome and evaluate its role as a biomarker for the diagnosis and mortality prediction of ICU sepsis patients
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