Serum Soluble Triggering Receptor Expressed on Myeloid Cells-1 and Procalcitonin Can Reflect Sepsis Severity and Predict Prognosis: A Prospective Cohort Study

Zhenyu Li,Jian Liu,Hongxia Wang,Guangping Li,Bing Chen

doi:10.1155/2014/641039

Abstract

Objective. To investigate the prognostic significance of serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), procalcitonin (PCT), N-terminal probrain natriuretic peptide (NT-pro-BNP), C-reactive protein (CRP), cytokines, and clinical severity scores in patients with sepsis. Methods. A total of 102 patients with sepsis were divided into survival group (n = 60) and nonsurvival group (n = 42) based on 28-day mortality. Serum levels of biomarkers and cytokines were measured on days 1, 3, and 5 after admission to an ICU, meanwhile the acute physiology and chronic health evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores were calculated. Results. Serum sTREM-1, PCT, and IL-6 levels of patients in the nonsurvival group were significantly higher than those in the survival group on day 1 (P < 0.01). The area under a ROC curve for the prediction of 28 day mortality was 0.792 for PCT, 0.856 for sTREM-1, 0.953 for SOFA score, and 0.923 for APACHE II score. Multivariate logistic analysis showed that serum baseline sTREM-1 PCT levels and SOFA score were the independent predictors of 28-day mortality. Serum PCT, sTREM-1, and IL-6 levels showed a decrease trend over time in the survival group (P < 0.05). Serum NT-pro-BNP levels showed the predictive utility from days 3 and 5 (P < 0.05). Conclusion. In summary, elevated serum sTREM-1 and PCT levels provide superior prognostic accuracy to other biomarkers. Combination of serum sTREM-1 and PCT levels and SOFA score can offer the best powerful prognostic utility for sepsis mortality.

Highlights

Sepsis is the major cause of death in the intensive care unit
There have been some biomarkers and cytokines used in both the clinical practice and laboratory including soluble triggering receptor expressed on myeloid cells-1, procalcitonin (PCT), N-terminal probrain natriuretic peptide (NT-pro-BNP), C-reactive protein (CRP), interleukin6 (IL-6), and interleukin-10 (IL-10)
PCT: procalcitonin; sTREM-1: soluble triggering receptor expressed on myeloid cells-1; NT-pro-BNP: Nterminal probrain natriuretic peptide; CRP: C-reactive protein; IL-6: interleukin-6; IL-10: interleukin-10

Summary

Introduction

Sepsis is the major cause of death in the intensive care unit. Despite improvement of antibiotics treatment and supportive techniques, the mortality of septic shock increases to approximately 60% [1]. Biomarkers are widely used to diagnose and manage sepsis. It helps doctors to make an early diagnosis of sepsis, and predicts outcomes. It should be available and cost cheap. There have been some biomarkers and cytokines used in both the clinical practice and laboratory including soluble triggering receptor expressed on myeloid cells-1 (strem-1), procalcitonin (PCT), N-terminal probrain natriuretic peptide (NT-pro-BNP), C-reactive protein (CRP), interleukin (IL-6), and interleukin-10 (IL-10). CRP is a widely used biomarker to discriminate the inflammatory response to sepsis [6]. IL-6 and IL-10 are important proinflammatory and anti-inflammatory cytokines during sepsis course

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Discussion

Conclusion