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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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.
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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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