Vocational School of Health Services, First Aid and Emergency Department, Izmir Tınaztepe University, Izmir, Turkey.
Faculty of Medicine, Department of Emergency Medicine, Dokuz Eylul University, Izmir, Turkey.
Niger J Clin Pract. 2021 May;24(5):680-684. doi: 10.4103/njcp.njcp_211_20.
Sepsis is a significant contributor of mortality all over the world. Emergency departments have a critical role for diagnosing a suspected sepsis in a patient, since early and proper administration of antibiotics may decrease mortality significantly. But, the unavailability of an objective and reliable diagnostic test is the major challenge of this critical issue.
The aim of this study is to evaluate the prognostic value of a novel biomarker, the ischemia-modified albumin (IMA) in patients with sepsis and septic shock in emergency department.
This prospective, observational study included 81 patients with sepsis or septic shock and 75 controls. Sociodemographic characteristics of the patients, site of infection, IMA levels, other biomarkers (procalcitonin, pH, lactate), mortality at 24-h and 28-day were evaluated.
The serum IMA levels in patient and control groups were 117.8 ± 85 IU/g and 115.8 ± 134.0 IU/g, respectively (P = 0.072). There was a weak but statistically significant positive correlation between IMA and lactate levels (P = 0.009). The mortality rates of patient group at 24-h and 28 days were 21% and 79%, respectively, but serum IMA levels were not found to be a prognostic marker to predict mortality.
The main reason for the similarity between groups regarding IMA levels was thought to be associated with the distribution of the acute and chronic health problems other than sepsis in the control group. Emergency department physicians should not only depend on serum IMA levels for predicting the prognosis of patients with sepsis or septic shock.
脓毒症是全球范围内导致死亡率的重要因素。急诊科在诊断疑似脓毒症患者方面发挥着关键作用，因为早期和适当的抗生素治疗可能显著降低死亡率。但是，缺乏客观可靠的诊断测试是这一关键问题的主要挑战。
本研究旨在评估一种新型生物标志物——缺血修饰白蛋白（IMA）在急诊科脓毒症和感染性休克患者中的预后价值。
这是一项前瞻性观察性研究，共纳入 81 例脓毒症或感染性休克患者和 75 例对照组。评估了患者的社会人口统计学特征、感染部位、IMA 水平、其他生物标志物（降钙素原、pH 值、乳酸）、24 小时和 28 天死亡率。
患者组和对照组的血清 IMA 水平分别为 117.8±85IU/g 和 115.8±134.0IU/g（P=0.072）。IMA 和乳酸水平之间存在弱但具有统计学意义的正相关（P=0.009）。患者组在 24 小时和 28 天的死亡率分别为 21%和 79%，但血清 IMA 水平并未被发现是预测死亡率的预后标志物。
认为导致两组之间 IMA 水平相似的主要原因是对照组中除脓毒症以外的急性和慢性健康问题的分布。急诊科医生不应仅依赖血清 IMA 水平来预测脓毒症或感染性休克患者的预后。
