Abstract
Objective: Sepsis remains an unsolved problem in hospitals since its mortality rate is not significantly reduced despite considerable therapy efforts. The most used prognostic tool is the Sepsis-related Organ Function (SOFA) score, which requires several clinical and laboratory examinations; our recent studies also showed that the protein carbonyl level (PCO) has prognostic value in predicting sepsis mortality.
 Methods: This prospective study was designed to assess the correlation between PCO values and the SOFA score following ethical approval. Adult patients aged>18 y who met the Sepsis-3 definition were included. Exclusion criteria were patients not admitted to the intensive care unit. Dropout criteria included mortality within the 1h bundle protocol. Baseline demographic data and blood collection were measured for all subjects. Subjects were treated with the 1h bundle protocol and observed for 28 d.
 Results: Fifty-nine subjects were included, with no significant differences in age, sex, diagnosis, microbiology or Charlson’s Comorbidity score between survivors and non-survivors. The SOFA score was higher in non-survivors (10.90±3.38 vs 8.11±3.07; p=0.003), as was the PCO value (24.5 [14.67-81] vs 18 [15-21.33]; p<0.001). However, the correlation between PCO and SOFA score is very weak (r=0.101; p=0.45).
 Conclusion: Both the PCO level and SOFA scores were higher in non-survivor septic patients. However, they have a very weak correlation and cannot be used interchangeably.
Highlights
Sepsis remains an unsolved problem in hospitals as well as in other critical care settings such as intensive care units and emergency rooms; its morbidity and mortality rate remains high
We found there was a positive correlation between the protein carbonyl level (PCO) level and the Sepsis-related Organ Failure Assessment (SOFA) score
This result did not support our assumption that the PCO level might replace the SOFA score as a predictor of sepsis mortality since the correlation was very weak and insignificant (r=0.101; p = 0.045)
Summary
Sepsis remains an unsolved problem in hospitals as well as in other critical care settings such as intensive care units and emergency rooms; its morbidity and mortality rate remains high. One-third of patients who die in the hospital suffer from sepsis [1]. Sepsis is the leading cause of mortality in the ICU, with a mortality rate of 25% in uncomplicated cases and 80% in multiple organ failure cases [2]. The sepsis mortality rate has not been significantly reduced. The most used prognostic tool is the Sepsis-related Organ Failure Assessment (SOFA) score. Current guidelines set a SOFA score of two or more points to represent lifethreatening organ dysfunctions in sepsis-related to the dysregulated host response to infection [3]. The score requires sequential examinations, including clinical and laboratory variables
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