Heparin binding protein as a reliable prognostic biomarker for severity of sepsis in the intensive care unit

Abstract

ABSTRACT Background It is still challenging to identify people who are at risk for developing sepsis quickly and early. Heparin-binding protein (HBP) has been demonstrated a promising data that can be used as predictive qualities in identifying organ failure. Methods This prospective observational investigation of 55 adult patients who have been proven to have sepsis, and were hospitalized into the intensive care unit. By carrying out HBP, procalcitonin (PROCAL), C-reactive protein (CRP), serum lactate, SOFA score on admission and after 72 hours and detecting 28-day mortality. Results Despite PROCAL and HBP were higher in survival than non-survival patients at day 0 (1010.32 ± 341.72 vs 770.21 ± 327.97, p = 0.0112) (16.73 ± 7.19 vs 13.19 ± 7.26, p = 0.077) respectively, It was significantly lower in survival than non-survival at day 3 (542.09 ± 191.98 vs 995.00 ± 333.74, p =<0.0001) (9.03 ± 2.92 vs 16.67 ± 7.55,p =<0.0001) respectively. Our main marker HBP decreased significantly from day 0 to day 3 for survival patients with paired difference −7.69 ± 6.78 with p value < 0.0001, while it is increased with non-significant value for non-survival patients with paired difference 3.48 ± 9.45 with p value 0.084. ROC analysis for mortality showed for HBP that AUC at day 0 was 0.323 (p=0.025). At cut-off value of>15.5ng/ml, sensitivity was 29.2%, specificity was 64.5%, while at day 3 was 0.831 (p=0.000). At cut-off value of>9.5ng/ml, sensitivity was 83.33%, specificity was 77.42%. Conclusion HPB showed a strong prognostic marker of mortality in ICU septic patients at day 3 more than day 0 with important value and trend.