The Effect of Cholinesterase Activity on the Diagnosis and Prognosis of Sepsis

Abstract

Background: There are many biomarkers defined for systemic inflammation and sepsis. Cholinesterase and its biological role is not entirely known but in recent studies, it was seen that cholinesterase levels had a diagnostic value in predicting both sepsis and mortality. Objective: The purpose of this study is to establish the role of cholinesterase activity as a biomarker in the early diagnosis and treatment planning of sepsis which is an uncontrolled inflammatory response of the host to an infection. Materials and Method: This is a controlled, observational, and prospective clinical study and has been carried out on patients admitted to the intensive care unit with sepsis. The demographic features, the medical history and vital findings of the patients were recorded. According to the intensive care monitoring and treatment procedures, the complete blood count test, urine test and routine biochemical assessments particularly the CRP, procalcitonin and blood gasses tests were performed and the serum cholinesterase activity was assessed. The data was digitalized and then analyzed using the SPSS 15.0 software package. Results: The cholinesterase levels detected in the patient group were lower than the cholinesterase levels of the control group and there was a significant difference between the groups (p< 0.001). A statistically significant association was detected between the severity of sepsis and the cholinesterase levels of the patients. There was also a statistical relationship between the cholinesterase levels and being connected to mechanical ventilation and the use of vasopressors (p<0.05). There was a significant association between mortality and cholinesterase levels (p= 0.009). As the cholinesterase activity decreased the mortality rate increased. As a result of the ROC analyses performed to establish the diagnostic value of the patients' cholinesterase levels in predicting sepsis and morality it was seen that cholinesterase levels had a diagnostic value in predicting both sepsis and mortality. Conclusions: We believe that the cholinesterase activity investigated in our study is an extremely useful biomarker in the diagnosis and prognosis prediction of the sepsis syndrome that progresses with systemic inflammation.