Clinical role of serum pre-B cell colony-enhancing factor in ventilated patients with sepsis and acute respiratory distress syndrome.

BACKGROUND: We measured serum levels of pre-B cell colony-enhancing factor (PBEF), which has been suggested as a novel biomarker of sepsis and acute respiratory distress syndrome (ARDS), and evaluated its use as a prognostic biomarker.
METHODS: PBEF was measured in 104 adult ventilated patients who were diagnosed with sepsis upon admission using an enzyme-linked immunosorbent assay.
RESULTS: The mean age of our patients was 62.9 ± 12.1 y, and 62 (59.6%) patients were male. The median PBEF level was 5.4 ng/ml (range 1.1-150.7 ng/ml). Non-survivors (n = 57) demonstrated significantly higher PBEF levels than survivors (18.7 ± 34.5 vs 6.9 ± 6.1 ng/ml; p = 0.022). Most particularly, patients with PBEF levels ≥ 10.4 ng/ml (n = 27) demonstrated higher hospital mortality than patients with PBEF levels < 10.4 ng/ml (n = 77) (74.1% vs. 48.1%; p = 0.025). Univariate logistic analysis determined PBEF ≥ 10.4 ng/ml to be an independent factor associated with hospital survival (hazard ratio = 0.324, 95% confidence interval = 0.123-0.854; p = 0.023). Among patients with sepsis-induced ARDS (n = 59), non-survivors (n = 35) demonstrated significantly higher PBEF levels than survivors (n = 24), but not interleukin-6 (IL-6) levels.
CONCLUSIONS: Our findings indicate that high PBEF is associated with poor clinical outcomes in ventilated patients with sepsis and sepsis-induced ARDS. Serum PBEF might be a better predictor of mortality than IL-6 in patients with sepsis-induced ARDS.