Abstract
Early prognostic prediction of sepsis is essential in adjusting therapeutic protocols to prevent deterioration and reduce mortality. We compared the predictive value of the serum concentration of the soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) for 28-day mortality and for the development of severe sepsis or septic shock on the third day with the levels of interleukin (IL)-6, C-reactive protein (CRP) and procalcitonin (PCT). The study was conducted on 85 patients with sepsis. sTREM-1, CRP, PCT and IL-6 concentrations were measured upon study inclusion (day 0) and on days 1, 2, 3 and 5. APACHE II, SAPS II and SOFA scores were analyzed. The sTREM-1 levels (pg/ml) were higher in non-survivors than in survivors at admission (773 vs. 391, p < 0.001) and on days 1, 2, 3 and 5. In predicting the development of severe sepsis, the highest AUCs were found for PCT (0.744, 95% CI 0.638–0.85) and sTREM-1 (0.664, 95% CI 0.55–0.778); and in septic shock prediction, for PCT (0.766, 95% CI 0.665–0.867) and IL-6 (0.707, 95% CI 0.595–0.819). sTREM-1 positively correlated with APACHE II, SAPS II and SOFA scores. At inclusion, significant AUC for predicting 28-day mortality was 0.772 for the sTREM-1 (95% CI 0.672–0.871), 0.858 for APACHE II (95% CI 0.768–0.948), 0.847 for SAPS II (95% CI 0.733–0.96), 0.806 for SOFA score (95% CI 0.698–0.915). sTREM-1 can early predict the 28-day sepsis mortality, although its effectiveness is lower in comparison with clinical severity scores.
Highlights
Despite considerable improvement in the pharmacological and supportive treatment of critical care patients, sepsis is one of the most frequent causes of hospital deaths, especially in intensive care units (ICUs) (Vincent et al 2006)
An increased serum sTREM-1 level was associated with sepsis severity, as assessed according to the APACHE II, SAPS II and sequential organ failure assessment (SOFA) scores, and predicted the 28-day mortality with a sensitivity and specificity
CI confidence interval, sTREM-1 soluble triggering receptor expressed on myeloid cells 1, SAPS II Simplified Acute Physiology Score II, APACHE II Acute Physiology and Chronic Health Evaluation II, SOFA sequential organ failure assessment
Summary
Despite considerable improvement in the pharmacological and supportive treatment of critical care patients, sepsis is one of the most frequent causes of hospital deaths, especially in intensive care units (ICUs) (Vincent et al 2006). The mortality rate of patients with sepsis has been decreasing for the last 20 years, it still ranges between 29–33% for severe sepsis cases and can exceed 60% among septic shock cases (Kübler et al 2015; Stevenson et al 2014). Diagnosis followed by prognostic sepsis assessment is crucial for providing effective treatment. Identifying patients at high risk of organ failure or shock is helpful when adjusting monitoring and treatment to prevent deterioration and to reduce mortality. There is a need for a simple method that would facilitate early prognosis. Many studies are being conducted to identify a biomarker with high prognostic accuracy for sepsis, severe sepsis and septic shock
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
