Elevations in presepsin, PCT, hs-CRP, and IL-6 levels predict mortality among septic patients in ICU.
J Leukoc Biol
; 2024 May 22.
Article
em En
| MEDLINE
| ID: mdl-38776408
ABSTRACT
BACKGROUND:
Aim to investigate the predictive value of changes in presepsin (PSEP), procalcitonin (PCT), high-sensitivity C-reactive protein (hsCRP), and interleukin-6 (IL-6) levels to for mortality in septic patients in intensive care unit (ICU).METHOD:
This study enrolled septic patients between November 2020 and December 2021. Levels of PSEP, PCT, hsCRP, and IL-6 were measured on 1st (PSEP_0, PCT_0, hsCRP_0, IL-6_0) and 3rd day (PSEP_3, PCT_3, hsCRP_3, IL-6_3). Follow-up was performed on days 3, 7, 14, 21, and 28 after enrollment. The outcome was all-cause death.RESULTS:
The study included 119 participants, and the mortality was 18.5%. In univariable Cox proportional-hazards regression (Cox) analysis, â³PSEP (= PSEP_3- PSEP_0) > 211.49â pg/ml (hazard ratio (HR) 2.70, 95% confidence interval (CI) 1.17-6.22), â³PCT (= PCT_3- PCT_0) > -0.13â ng/ml (HR 7.31, 95% CI 2.68-19.80), â³hsCRP (= hsCRP_3- hsCRP_0) > -19.29â mg/L (HR 6.89, 95% CI 1.61-29.40), and â³IL-6 (= IL-6_3- IL-6_0) > 1.00â pg/ml (HR 3.13, 95% CI 1.35-7.24) indicated an increased risk of mortality. The composite concordance index for alterations in all four distinct biomarkers was highest (concordance index 0.83, 95% CI 0.76-0.91), suggesting the optimal performance of this panel in mortality prediction. In decision curve analysis, compared with the APACHE â ¡ and SOFA scores, the combination of the four biomarkers had a larger net benefit. Interestingly, IL-6 was predominantly produced by monocytes upon LPS stimulation in PBMCs.CONCLUSIONS:
â³PSEP, â³PCT, â³hsCRP, and â³IL-6 are reliable biomarkers for predicting mortality in septic patients in ICU, and their combination has the best performance.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
J Leukoc Biol
Ano de publicação:
2024
Tipo de documento:
Article