Yongzhen Zhao1, Yumei Jia2, Chunsheng Li3, Yingying Fang4, Rui Shao4. 1. Department of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Cardiopulmonary-Cerebral Resuscitation, Beijing Chaoyang Hospital, Capital Medical University, Beijing,China. 2. Department of Endocrinology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China. 3. Beijing Key Laboratory of Cardiopulmonary-Cerebral Resuscitation, Beijing Chaoyang Hospital, Capital Medical University, Beijing,China. Electronic address: lcscyyy@163.com. 4. Beijing Key Laboratory of Cardiopulmonary-Cerebral Resuscitation, Beijing Chaoyang Hospital, Capital Medical University, Beijing,China.
Abstract
OBJECTIVE: To evaluate the efficacy of soluble programmed death-1 (sPD-1) for risk stratification and prediction of 28-day mortality in patients with sepsis, we compared serum sPD-1 with procalcitonin (PCT), C-reactive protein (CRP), and the Mortality in Emergency Department Sepsis (MEDS) score. METHODS: A total of 60 healthy volunteers and 595 emergency department (ED) patients were recruited for this prospective cohort study. According to the severity of their condition on ED arrival, the patients were allocated to the systemic inflammatory response syndrome group (130 cases), sepsis group (276 cases), severe sepsis group (121 cases), and septic shock group (68 cases). In addition, all patients with sepsis were also divided into the survivor group (349 cases) and nonsurvivor group (116 cases) according to the 28-day outcomes. RESULTS: When the severity of sepsis increased, the levels of sPD-1 gradually increased. The levels of sPD-1, PCT, CRP and the MEDS score were also higher in the nonsurvivor group compared to the survivor group. Logistic regression suggested that sPD-1, PCT, and the MEDS score were independent risk factors for 28-day mortality of patients with sepsis. Area under the curve (AUC) of sPD-1, PCT and the MEDS score for 28-day mortality was 0.725, 0.693, and 0.767, respectively, and the AUC was improved when all 3 factors were combined (0.843). CONCLUSION: Serum sPD-1 is positively correlated with the severity of sepsis, and it is valuable for risk stratification of patients and prediction of 28-day mortality. Combining sPD-1 with PCT and the MEDS score improves the prognostic evaluation.
OBJECTIVE: To evaluate the efficacy of soluble programmed death-1 (sPD-1) for risk stratification and prediction of 28-day mortality in patients with sepsis, we compared serum sPD-1 with procalcitonin (PCT), C-reactive protein (CRP), and the Mortality in Emergency Department Sepsis (MEDS) score. METHODS: A total of 60 healthy volunteers and 595 emergency department (ED) patients were recruited for this prospective cohort study. According to the severity of their condition on ED arrival, the patients were allocated to the systemic inflammatory response syndrome group (130 cases), sepsis group (276 cases), severe sepsis group (121 cases), and septic shock group (68 cases). In addition, all patients with sepsis were also divided into the survivor group (349 cases) and nonsurvivor group (116 cases) according to the 28-day outcomes. RESULTS: When the severity of sepsis increased, the levels of sPD-1 gradually increased. The levels of sPD-1, PCT, CRP and the MEDS score were also higher in the nonsurvivor group compared to the survivor group. Logistic regression suggested that sPD-1, PCT, and the MEDS score were independent risk factors for 28-day mortality of patients with sepsis. Area under the curve (AUC) of sPD-1, PCT and the MEDS score for 28-day mortality was 0.725, 0.693, and 0.767, respectively, and the AUC was improved when all 3 factors were combined (0.843). CONCLUSION: Serum sPD-1 is positively correlated with the severity of sepsis, and it is valuable for risk stratification of patients and prediction of 28-day mortality. Combining sPD-1 with PCT and the MEDS score improves the prognostic evaluation.
Authors: Debasree Banerjee; Sean Monaghan; Runping Zhao; Thomas Walsh; Amy Palmisciano; Gary S Phillips; Steven Opal; Mitchell M Levy Journal: Crit Care Date: 2018-06-07 Impact factor: 9.097
Authors: Kirby Tong-Minh; Iris Welten; Henrik Endeman; Tjebbe Hagenaars; Christian Ramakers; Diederik Gommers; Eric van Gorp; Yuri van der Does Journal: BMC Emerg Med Date: 2021-06-13