Pentraxin 3 PTX3 Is Associated with Severe Sepsis and Fatal Disease in Emergency Room Patients with Suspected Infection: A Prospective Cohort StudyReportar como inadecuado




Pentraxin 3 PTX3 Is Associated with Severe Sepsis and Fatal Disease in Emergency Room Patients with Suspected Infection: A Prospective Cohort Study - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Background

Early diagnostic and prognostic stratification of patients with suspected infection is a difficult clinical challenge. We studied plasma pentraxin 3 PTX3 upon admission to the emergency department in patients with suspected infection.

Methods

The study comprised 537 emergency room patients with suspected infection: 59 with no systemic inflammatory response syndrome SIRS and without bacterial infection group 1, 67 with bacterial infection without SIRS group 2, 54 with SIRS without bacterial infection group 3, 308 with sepsis SIRS and bacterial infection without organ failure group 4 and 49 with severe sepsis group 5. Plasma PTX3 was measured on admission using a commercial solid-phase enzyme-linked immunosorbent assay ELISA.

Results

The median PTX3 levels in groups 1–5 were 2.6 ng-ml, 4.4 ng-ml, 5.0 ng-ml, 6.1 ng-ml and 16.7 ng-ml, respectively p<0.001. The median PTX3 concentration was higher in severe sepsis patients compared to others 16.7 vs. 4.9 ng-ml, p<0.001 and in non-survivors day 28 case fatality compared to survivors 14.1 vs. 5.1 ng-ml, p<0.001. A high PTX3 level predicted the need for ICU stay p<0.001 and hypotension p<0.001. AUCROC in the prediction of severe sepsis was 0.73 95% CI 0.66–0.81, p<0.001 and 0.69 in case fatality 95% CI 0.58–0.79, p<0.001. PTX3 at a cut-off level for 14.1 ng-ml optimal cut-off value for severe sepsis showed 63% sensitivity and 80% specificity. At a cut-off level 7.7 ng-ml optimal cut-off value for case fatality showed 70% sensitivity and 63% specificity in predicting case fatality on day 28.In multivariate models, high PTX3 remained an independent predictor of severe sepsis and case fatality after adjusting for potential confounders.

Conclusions

A high PTX3 level on hospital admission predicts severe sepsis and case fatality in patients with suspected infection.



Autor: Raija Uusitalo-Seppälä , Reetta Huttunen, Janne Aittoniemi, Pertti Koskinen, Aila Leino, Tero Vahlberg, Esa M. Rintala

Fuente: http://plos.srce.hr/



DESCARGAR PDF




Documentos relacionados