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Use of Biomarkers to Improve 28-Day Mortality Stratification in Patients with Sepsis and SOFA ≤ 6
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 s...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452503/ https://www.ncbi.nlm.nih.gov/pubmed/37626646 http://dx.doi.org/10.3390/biomedicines11082149 |
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author | Baldirà, Jaume Ruiz-Rodríguez, Juan Carlos Ruiz-Sanmartin, Adolfo Chiscano, Luis Cortes, Alejandro Sistac, Diego Ángeles Ferrer-Costa, Roser Comas, Inma Villena, Yolanda Larrosa, Maria Nieves González-López, Juan José Ferrer, Ricard |
author_facet | Baldirà, Jaume Ruiz-Rodríguez, Juan Carlos Ruiz-Sanmartin, Adolfo Chiscano, Luis Cortes, Alejandro Sistac, Diego Ángeles Ferrer-Costa, Roser Comas, Inma Villena, Yolanda Larrosa, Maria Nieves González-López, Juan José Ferrer, Ricard |
author_sort | Baldirà, Jaume |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-10452503 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-104525032023-08-26 Use of Biomarkers to Improve 28-Day Mortality Stratification in Patients with Sepsis and SOFA ≤ 6 Baldirà, Jaume Ruiz-Rodríguez, Juan Carlos Ruiz-Sanmartin, Adolfo Chiscano, Luis Cortes, Alejandro Sistac, Diego Ángeles Ferrer-Costa, Roser Comas, Inma Villena, Yolanda Larrosa, Maria Nieves González-López, Juan José Ferrer, Ricard Biomedicines Article 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. MDPI 2023-07-30 /pmc/articles/PMC10452503/ /pubmed/37626646 http://dx.doi.org/10.3390/biomedicines11082149 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Baldirà, Jaume Ruiz-Rodríguez, Juan Carlos Ruiz-Sanmartin, Adolfo Chiscano, Luis Cortes, Alejandro Sistac, Diego Ángeles Ferrer-Costa, Roser Comas, Inma Villena, Yolanda Larrosa, Maria Nieves González-López, Juan José Ferrer, Ricard Use of Biomarkers to Improve 28-Day Mortality Stratification in Patients with Sepsis and SOFA ≤ 6 |
title | Use of Biomarkers to Improve 28-Day Mortality Stratification in Patients with Sepsis and SOFA ≤ 6 |
title_full | Use of Biomarkers to Improve 28-Day Mortality Stratification in Patients with Sepsis and SOFA ≤ 6 |
title_fullStr | Use of Biomarkers to Improve 28-Day Mortality Stratification in Patients with Sepsis and SOFA ≤ 6 |
title_full_unstemmed | Use of Biomarkers to Improve 28-Day Mortality Stratification in Patients with Sepsis and SOFA ≤ 6 |
title_short | Use of Biomarkers to Improve 28-Day Mortality Stratification in Patients with Sepsis and SOFA ≤ 6 |
title_sort | use of biomarkers to improve 28-day mortality stratification in patients with sepsis and sofa ≤ 6 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452503/ https://www.ncbi.nlm.nih.gov/pubmed/37626646 http://dx.doi.org/10.3390/biomedicines11082149 |
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