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前降钙素不能预测入住重症监护病房的脓毒症患者的死亡风险:一项前瞻性单中心研究。

Presepsin Does Not Predict Risk of Death in Sepsis Patients Admitted to the Intensive Care Unit: A Prospective Single-Center Study.

作者信息

Pluta Michał P, Czempik Piotr F, Kwiatkowska Magdalena, Marczyk-Bełbot Katarzyna, Maślanka Sebastian, Mika Jolanta, Krzych Łukasz J

机构信息

Department of Acute Medicine, Medical University of Silesia, 41800 Zabrze, Poland.

Department of Cardiac Anesthesia and Intensive Therapy, Silesian Center for Heart Diseases, 41800 Zabrze, Poland.

出版信息

Biomedicines. 2024 Oct 11;12(10):2313. doi: 10.3390/biomedicines12102313.

Abstract

: Sepsis is defined as life-threatening organ dysfunction caused by an abnormal host response to infection. The study aimed to evaluate the utility of presepsin (P-SEP) in predicting the risk of death in patients with sepsis at the time of intensive care unit (ICU) admission. : Adult patients were included in the study if they met SEPSIS-3 criteria at ICU admission. Demographic and clinical data were collected. The following inflammatory parameters were determined: C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), and presepsin (P-SEP). Material was collected for microbiological testing depending on the suspected source of infection. The primary endpoint was patient death before ICU discharge. The secondary endpoint was a positive microbiological test result. : Eighty-six patients were included in the study. Thirty patients (35%) died before discharge from the ICU. There was no difference in P-SEP, CRP, PCT, and IL-6 values between patients who survived and those who died ( > 0.05 for all). P-SEP, CRP, PCT, and IL-6 were determined at ICU admission and did not accurately predict the risk of death in ROC curve analysis ( > 0.05 for all). Confirmation of the location of the focus of bacterial infection by microbiological testing was obtained in 43 (49%) patients. P-SEP, PCT, CRP, and IL-6 were significantly higher in patients with positive microbiological findings. : In patients with suspected sepsis admitted to the Intensive Care Unit, presepsin does not accurately predict the risk of in-hospital death, but it can predict a positive microbiological culture.

摘要

脓毒症的定义是由宿主对感染的异常反应引起的危及生命的器官功能障碍。本研究旨在评估前降钙素原(P-SEP)在预测脓毒症患者入住重症监护病房(ICU)时死亡风险中的作用。

纳入标准为入住ICU时符合SEPSIS-3标准的成年患者。收集人口统计学和临床数据。测定以下炎症参数:C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)和前降钙素原(P-SEP)。根据怀疑的感染源采集样本进行微生物检测。主要终点是患者在ICU出院前死亡。次要终点是微生物检测结果为阳性。

本研究共纳入86例患者。30例(35%)患者在ICU出院前死亡。存活患者和死亡患者的P-SEP、CRP、PCT和IL-6值无差异(均P>0.05)。在入住ICU时测定的P-SEP、CRP、PCT和IL-6在受试者工作特征曲线分析中均不能准确预测死亡风险(均P>0.05)。43例(49%)患者通过微生物检测确定了细菌感染病灶的位置。微生物检测结果为阳性的患者中,P-SEP、PCT、CRP和IL-6显著升高。

在入住重症监护病房的疑似脓毒症患者中,前降钙素原不能准确预测院内死亡风险,但可预测微生物培养结果为阳性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c3f/11504983/d2b6801a66f1/biomedicines-12-02313-g001.jpg

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