Pentraxin-3 Is a Strong Biomarker of Sepsis Severity Identification and Predictor of 90-Day Mortality in Intensive Care Units via Sepsis 3.0 Definitions

Huan Chen,Meidong Liu,Tao Li,Shanshan Yan,Min Gao,Huali Zhang,Ke Liu,Xianzhong Xiao

doi:10.3390/diagnostics11101906

Huan Chen, Meidong Liu + Show 6 more

Open Access

https://doi.org/10.3390/diagnostics11101906

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Abstract

Background: Sepsis is the leading cause of mortality in intensive care units (ICUs). However, early diagnosis and prognosis of sepsis and septic shock are still a great challenge. Pentraxin-3 (PTX3) was shown to be associated with the severity and outcome of sepsis and septic shock. This study was carried out to investigate the diagnostic and prognostic value of PTX3 in patients with sepsis and septic shock based on Sepsis 3.0 definitions. Methods: In this single-center prospective observational study, all patients’ serum was collected for biomarker measurements within 24 h after admission. Logistic and Cox regression analyses were used to identify the potential biomarkers of diagnosis, severity stratification, and prediction. Results: Serum levels of PTX3 were significantly increased on the first day of ICU admission, while septic shock patients had highest PTX3 levels than other groups. A combination between PTX3 and procalcitonin (PCT) could better discriminate sepsis and septic shock, and PTX3 was an independent predictor of mortality in sepsis and septic shock patients. Conclusion: PTX3 may be a robust biomarker to classify the disease severity and predict the 90-day mortality of sepsis and septic shock based on the latest Sepsis 3.0 definitions.

Highlights

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection, the leading cause of death in intensive care units (ICUs) [1,2]
In terms of investigating the diagnostic value of early detection of PTX3, we found that PTX3, PCT, lactate, and platelet count could distinguish septic shock patients from other patients admitted to the ICU with the best performance
We found that PTX3 combined with PCT could improve the diagnostic value to distinguish between septic shock patients and other critically ill patients, paying more attention to managing patients at high risk in time

Summary

Introduction

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection, the leading cause of death in intensive care units (ICUs) [1,2]. Considering the complexity of pathogenesis, variability of clinical phenotypes, and high mortality of sepsis and septic shock, a more accurate recognition and risk stratification of these clinical syndromes would allow precise therapeutic strategies and improve patients’ quality of life [5]. In these circumstances, serum biomarkers may improve early diagnosis and severity classification and implement targeted management and appropriate therapies. Conclusion: PTX3 may be a robust biomarker to classify the disease severity and predict the 90-day mortality of sepsis and septic shock based on the latest Sepsis 3.0 definitions

Methods

Results

Conclusion