Prognostication of Mortality in Critically 111 Patients With Severe Infections

Que, Yok-Ai; Guessous, Idris; Dupuis-Lozeron, Elise; Oliveira, Clara Rodrigues Alves de; Oliveira, Carolina; Graf, Rolf; Seematter, G.; Revelly, Jean-Pierre; Pagani, Jean‐Luc; Liaudet, Lucas; Nobre, Vandack; Eggimann, Philippe

doi:10.1378/chest.15-0123

Cited by 22 publications

(17 citation statements)

References 46 publications

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“…Procalcitonin (PCT), which is a novel marker of inflammation and infection, has been widely investigated for its prognostic value in septic patients. Although studies have produced conflicting results [30][31][32][33][34][35][36], Tasdelen Fisgin et al [30] and Hensler et al [32] demonstrated that neopterin was a better prognostic factor than PCT in patients with sepsis.…”

Section: Discussionmentioning

confidence: 99%

Oxidative stress parameters and inflammatory and immune mediators as markers of the severity of sepsis

Bavunoğlu

Genc

Konukoğlu

et al. 2016

J Infect Dev Ctries

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Introduction: Sepsis is a complex inflammatory syndrome with diverse etiology and wide spectrum of severity. The aim of this study was to investigate whether inflammatory mediators, in comparison with oxidative parameters, are associated with severity of sepsis. Methodology: Plasma neopterin, adenosine deaminase (ADA), vascular cell adhesion molecule (VCAM), intracellular adhesion molecule (ICAM), interleukin (IL)-1, IL-6, and tumor necrosis factor alpha (TNF-α), as inflammatory mediators, and serum nitric oxide (NOx), nitrotyrosine (NT), oxidized LDL (oxLDL) levels, serum paraoxonase 1 (PON1) activity, and erythrocyte glutathione (GSH) levels as oxidative stress parameters of 12 patients with mild sepsis, 25 patients with severe sepsis, and 20 healthy control subjects were evaluated. NOx, GSH levels and PON1 activity were determined by colorimetric methods, whereas neopterin, VCAM, ICAM, IL-1, IL-6, TNF-α, NT, and oxLDL levels were measured by enzyme-linked immunosorbent assay (ELISA). Results: All parameters in mild and severe sepsis were significantly different from those of healthy subjects, except ADA activities. Patients with severe sepsis exhibited higher IL-6, TNF-α, NT, and oxLDL levels than patients with mild sepsis. GSH (98%, 98%), oxLDL (98%, 98%), VCAM-1 (99%, 99%), and ICAM-1 (99%, 99%) have much more sensitivitiy and specificity in sepsis. Conclusions: Our results suggest that the oxidative stress and inflammatory response in patients with sepsis were increased and that serum IL-6, TNF-α, NT, and oxLDL levels were correlated with the severity of sepsis. Therefore, increases in these parameters may contribute to the dysfunction or failure of one or more organs, or even death, in sepsis.

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Section: Discussionmentioning

confidence: 99%

Oxidative stress parameters and inflammatory and immune mediators as markers of the severity of sepsis

Bavunoğlu

Genc

Konukoğlu

et al. 2016

J Infect Dev Ctries

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“…Data collection was performed as previously described [6,7]. Severity of the illness was evaluated on the first day in the ICU by using the Acute Physiology and Chronic Health Evaluation II (APACHE II) score [36].…”

Section: Methodsmentioning

confidence: 99%

“…However, insufficient sensitivity and specificity of these measurements prevent currently their use for early diagnosis of sepsis and management [3–5]. We recently confirmed the prognostic value of pancreatic stone protein to predict, in combination with severity scores, the outcome of patients with sepsis requiring ICU management [6,7]. However, it is necessary to identify novel sepsis biomarkers [5,8].…”

Section: Introductionmentioning

confidence: 99%

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Study of Early Elevated Gas6 Plasma Level as a Predictor of Mortality in a Prospective Cohort of Patients with Sepsis

et al. 2016

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BackgroundGrowth arrest-specific gene 6 (Gas6), a vitamin K-dependent protein interacting with anionic phospholipids and TAM tyrosine kinase receptors, is elevated in plasma of septic patients. Previous studies did not find different levels between survivors and non-survivors at admission because either they included a low number of patients (<50) or a low number of non-survivors (5%).ObjectivesTo determine, in a larger cohort of septic patients comprising an expected number of non-survivors, the performance of the plasma level of Gas6 and its soluble receptor Axl (sAxl) within 24 hours of admission to predict in-ICU mortality.PatientsSeptic adults with or without shock.MethodsGas6 and sAxl were prospectively measured by ELISA at day 0, 3, 7, and then weekly until discharge or death.ResultsWe evaluated 129 septic patients, including 82 with and 47 without shock, with in-ICU mortality rate of 19.4% and in-hospital mortality rate of 26%. Gas6 level was higher in non-survivors than in survivors (238 vs. 167%, P = 0.003); this difference remained constant during the ICU stay. The area under the ROC curve for Gas6 (0.695 [95% CI: 0.58–0.81]) was higher than for sAxl, procalcitonin, CRP, IL-1beta, IL-6 and-alpha, and slightly higher than for IL-8, IL-10, SOFA and APACHEII scores in predicting in-ICU mortality. Considering 249% as a cut-off value, Gas6 measurement had a negative predictive value for mortality of 87%.ConclusionIt seems that Gas6 plasma level within 24 hours of ICU admission may predicts in-ICU mortality in patients with sepsis. If our result are confirmed in external validation, Gas6 plasma level measurement could contribute to the identification of patients who may benefit most from more aggressive management.

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“…Positive test results for these markers, and especially for PCT, even at low levels, can be used as an acceptable guide for antibiotic administration (8)(9)(10)(11)(12). These markers are valuable in checking the treatment responses and incidence of complications, especially in cases of acute exacerbation of COPD, where they are of great importance in the initiation of antibiotic administration (3,8).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Serum Levels of Procalcitonin and C-Reactive Protein in Patients with Community Acquired Pneumonia and COPD Exacerbation

Taghizadieh

Soleimanpour

Rahmani

et al. 2016

Iran Red Crescent Med J

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Prognostication of Mortality in Critically 111 Patients With Severe Infections

Cited by 22 publications

References 46 publications

Oxidative stress parameters and inflammatory and immune mediators as markers of the severity of sepsis

Oxidative stress parameters and inflammatory and immune mediators as markers of the severity of sepsis

Study of Early Elevated Gas6 Plasma Level as a Predictor of Mortality in a Prospective Cohort of Patients with Sepsis

Comparison of Serum Levels of Procalcitonin and C-Reactive Protein in Patients with Community Acquired Pneumonia and COPD Exacerbation

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