Abstract
BackgroundWe examined the utility of serum levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for the diagnoses, severity assessments, and predicting the prognoses of patients with sepsis and compared sTREM-1 values with those of C-reactive protein (CRP) and procalcitonin (PCT).MethodsFifty-two patients with sepsis were included: 15 sepsis cases and 37 severe sepsis cases (severe sepsis + septic shock). Serum levels of sTREM-1, CRP, and PCT were determined on days 1, 3, 5, 7, 10, and 14 after admission to an ICU.ResultsSerum sTREM-1 levels of patients with severe sepsis were significantly higher than for those with sepsis on day 1 (240.6 pg/ml vs. 118.3 pg/ml; P < 0.01), but CRP and PCT levels were not significantly different between the two groups. The area under an ROC curve for sTREM-1 for severe sepsis patients was 0.823 (95% confidence interval: 0.690-0.957). Using 222.5 pg/ml of sTREM-1 as the cut-off value, the sensitivity was 59.5%, the specificity was 93.3%, the positive predictive value was 95.6%, the negative predictive value was 48.3%, the positive likelihood ratio was 8.92, and the negative likelihood ratio was 0.434. Based on 28-day survivals, sTREM-1 levels in the surviving group showed a tendency to decrease over time, while they tended to gradually increase in the non-surviving group. sTREM-1 levels in the non-surviving group were higher than those in the surviving group at all time points, whereas CRP and PCT levels showed a tendency to decrease over time in both groups. sTREM-1 levels and Sequential Organ Failure Assessment (SOFA) scores were positively correlated (r = 0.443; P < 0.001), and this correlation coefficient was greater than the correlation coefficients for both CRP and PCT.ConclusionsSerum sTREM-1 levels reflected the severity of sepsis more accurately than those of CRP and PCT and were more sensitive for dynamic evaluations of sepsis prognosis.Trial RegistrationCurrent controlled trials ChiCTR-OCH-09000745
Highlights
We examined the utility of serum levels of soluble triggering receptor expressed on myeloid cells-1 for the diagnoses, severity assessments, and predicting the prognoses of patients with sepsis and compared sTREM-1 values with those of C-reactive protein (CRP) and procalcitonin (PCT)
Triggering receptor expressed on myeloid cells-1 (TREM-1), discovered by Bouchon et al in 2000 [1], is a member of the immunoglobulin superfamily of receptors that is expressed on the surfaces of monocytes and neutrophils
1 levels as an indicator of sepsis was superior to CRP and PCT, other studies reported that the value of sTREM-1 for diagnosing sepsis was inferior to CRP and PCT [3,4,5]
Summary
We examined the utility of serum levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for the diagnoses, severity assessments, and predicting the prognoses of patients with sepsis and compared sTREM-1 values with those of C-reactive protein (CRP) and procalcitonin (PCT). It is highly desirable to find sensitive and specific indicators of infection that can be collected, that accurately reflect infection severity and prognosis and are clinically. 1 levels as an indicator of sepsis was superior to CRP and PCT, other studies reported that the value of sTREM-1 for diagnosing sepsis was inferior to CRP and PCT [3,4,5]. The purpose of this study was to track changes in serum sTREM-1, CRP and PCT levels in patients with sepsis and to compare the predictive values of these three factors for assessing sepsis and establishing prognosis
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