How Well do Serum sTREM-1 Measurements Prognosticate in Septic Shock?

Abstract

The soluble triggering receptor expressed on myeloid cells (sTREM)-1 has emerged as a potentially useful biomarker for the diagnosis of sepsis. This study aimed to evaluate the prognostic utility of serum sTREM-1 in septic shock, in comparison with that of procalcitonin measurements. Thirty-one consecutive patients in a tertiary medical intensive care unit with septic shock were studied. sTREM-1 levels in blood were measured using a modified immunoblot array technique on days one to three of intensive care unit admission. Serum procalcitonin and interleukin (IL)-1ß, IL-6, IL-10 and tumour necrosis factor-α levels were also measured. No significant difference was observed in the sTREM-1 levels on the first three days between survivors and nonsurvivors. sTREM-1 levels moderately correlated with the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores on day three, but did not correlate with vasopressor requirements, cytokine levels and the presence of bacteraemia. In contrast, procalcitonin levels were significantly higher in nonsurvivors than in survivors on days two and three. A significant relationship also existed between procalcitonin levels and the other variables. In conclusion, this study found that the prognostic utility of serum sTREM-1 in septic shock is poor and that procalcitonin measurements perform better in this regard.

sTREM-1 predicts intensive care unit and 28-day mortality in cancer patients with severe sepsis and septic shock

“…Although sTREM-1 was lower in the cancer group, those patients who died had higher levels. These finding is in accordance with some authors investigating noncancer patients with sepsis [14,16,36,37], and in one retrospective study including patients with chemotherapy-associated febrile neutropenia, higher levels of sTREM-1 demonstrated good correlation with severity and the development of complications [17]. The reduced levels of sTREM-1 found in patients with cancer might be associated with the reduction in total leukocyte and neutrophil counts.…”

“…In previous studies including noncancer patients, sTREM-1 showed a strong association with sepsis diagnosis [12,13,16]. Although sTREM-1 was lower in the cancer group, those patients who died had higher levels.…”

“…sTREM-1 plasma levels were associated with the diagnosis of sepsis [12,13]. Some authors demonstrated a good correlation of sTREM-1 with the severity and prognosis of sepsis [14], but others failed to demonstrate it [15,16]. One single-center study reported that sTREM-1 levels on admission were an independent predictor of survival in patients with severe sepsis [38].…”

Serum Soluble Triggering Receptor Expressed on Myeloid Cells-1 and Procalcitonin Can Reflect Sepsis Severity and Predict Prognosis: A Prospective Cohort Study

“…All these data indicated that strem-1 could serve as an indicator for sepsis prognosis. Some studies failed to find the association between strem-1 and poor outcome [8, 13]. At a cutoff of 252.05 pg/mL, strem-1 measurements yielded a sensitivity of 85.7%, specificity of 75.7%, positive predictive value of 70.6%, negative predictive value of 88.2%, and an accuracy of 79.4% for differentiating nonsurvivors from survivors.…”

“…Gibot et al [7] indicated that sTREM-1 was more accurate than PCT and CRP in the diagnosis of sepsis, but others showed that the prognostic utility of serum sTREM-1 in septic shock was inferior to that of PCT [8]. The prognostic value of biomarkers mentioned above for sepsis is unclear.…”