Use of Biomarkers to Improve 28-Day Mortality Stratification in Patients with Sepsis and SOFA ≤ 6
Baldira Martínez de Irujo, Jaume (Institut d'Investigació Biomèdica Sant Pau)
Ruiz-Rodriguez, Juan Carlos (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Ruiz-Sanmartin, Adolfo (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Chiscano-Camón, Luis (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Cortes, Alejandro (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Sistac, Diego Ángeles (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Ferrer Costa, Roser (Hospital Universitari Vall d'Hebron)
Comas, Inma (Hospital Universitari Vall d'Hebron)
Villena-Ortiz, Yolanda (Hospital Universitari Vall d'Hebron)
Larrosa, María Nieves (Hospital Universitari Vall d'Hebron)
González, Juan José (Hospital Universitari Vall d'Hebron)
Ferrer, Ricard (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	Early diagnosis and appropriate treatments are crucial to reducing mortality risk in septic patients. Low SOFA scores and current biomarkers may not adequately discern patients that could develop severe organ dysfunction or have an elevated mortality risk. The aim of this prospective observational study was to evaluate the predictive value of the biomarkers mid-regional pro-adrenomedullin (MR-proADM), procalcitonin (PCT), C-reactive protein (CRP), and lactate for 28-day mortality in patients with sepsis, and patients with a SOFA score ≤6. 284 were included, with a 28-day all-cause mortality of 8. 45% (n = 24). Non-survivors were older (p = 0. 003), required mechanical ventilation (p = 0. 04), were ventilated for longer (p = 0. 02), and had higher APACHE II (p = 0. 015) and SOFA (p = 0. 027) scores. Lactate showed the highest predictive ability for all-cause 28-day mortality, with an area under the receiver-operating characteristic curve (AUROC) of 0. 67 (0. 55-0. 79). The AUROC for all-cause 28-day mortality in patients with community-acquired infection was 0. 69 (0. 57-0. 84) for SOFA and 0. 70 (0. 58-0. 82) for MR-proADM. A 2. 1 nmol/L cut-off point for this biomarker in this subgroup of patients discerned, with 100% sensibility, survivors from non-survivors at 28 days. In patients with community-acquired sepsis and initial SOFA score ≤ 6, MR-proADM could help identify patients at risk of 28-day mortality.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Lactate ; MR-proADM ; Molecular diagnosis ; Mortality ; Sepsis biomarkers ; SOFA score
Publicat a:	Biomedicines, Vol. 11 (july 2023) , ISSN 2227-9059

DOI: 10.3390/biomedicines11082149
PMID: 37626646

12 p, 1.6 MB

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