Abstract
Purpose of Research:to determine whether we can use free hemoglobin concentration as early prognostic marker and a predictor of mortality in sepsis.Materials and Methods.In a retrospective study in 60 patients aged 47.6 ± 7.2 years with sepsis (30.4 ± 2.1 points on the Mannheim’s scale for evaluation of the severity of peritonitis) modern methods of statistics (ROC-analysis) hypothesis was tested, whether level of free hemoglobin in the first 24 hours from the moment of admission can be used as a biomarker for diagnosis and prognosis for severe sepsis. Informative criterion was compared with the information of the procalcitonin test.Results.The present study had shown that the above average free hemoglobin concentration, measured on the first day of the heavy flow of sepsis, is directly connected with increased 30-days mortality, and the level of free hemoglobin in a first day of the disease has high sensitivity, specificity, and can determine the outcome of sepsis with accuracy up to 96.7 %.Conclusion.Free hemoglobin concentration above medium size identified on the first day of the currents of severe sepsis, is directly related to increased 30-day mortality, and researched level of free hemoglobin in day 1 of the disease has a high proportion of sensitivity and specificity. Level of free hemoglobin is predictor outcome of sepsis in the first 24 hours after the start of therapy, but the results did not rule out the need to use the necessary test from septic patients, but rather the feasibility of combining the two dictates the criteria to assess the outcome of severe septic process that requires further research.
Highlights
In a retrospective study in 60 patients aged 47.6 ± 7.2 years with sepsis (30.4 ± 2.1 points on the Mannheim’s scale for evaluation of the severity of peritonitis) modern methods of statistics (ROC-analysis) hypothesis was tested, whether level of free hemoglobin in the first 24 hours from the moment of admission can be used as a biomarker for diagnosis and prognosis for severe sepsis
Informative criterion was compared with the information of the procalcitonin test
The present study had shown that the above average free hemoglobin concentration, measured on the first day of the heavy flow of sepsis, is directly connected with increased 30-days mortality, and the level of free hemoglobin in a first day of the disease has high sensitivity, specificity, and can determine the outcome of sepsis with accuracy up to 96.7 %
Summary
В исследовании у 60 пациентов в возрасте 47,6 ± 7,2 года с сепсисом (30,4 ± 2,1 балла по шкале Манхейма для оценки тяжести перитонита) методами современной статистики (ROC-анализ) была проверена гипотеза, действительно ли уровень свободного гемоглобина, определяемый в первые сутки от момента госпитализации, может быть использован в качестве биомаркера для диагностики и прогноза тяжелого сепсиса. Уровень свободного гемоглобина является чувствительным предиктором исхода сепсиса в первые сутки после начала терапии, но полученные результаты никак не исключают необходимости использования прокальцитонинового теста у септических пациентов, а напротив, диктуют целесообразность сочетания двух указанных критериев для оценки исхода тяжелого септического процесса, что требует продолжения исследований. В условиях гипоперфузии в спланхническом кровотоке создаются условия, при которых значительное количество эритроцитов подвергается повреждению, обусловливая последующий гемолиз и появление в кровотоке большого количества свободного гемоглобина, который, на наш взгляд, может служить одним из ранних маркеров тяжелого абдоминального сепсиса.
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