Complement related pattern recognition molecules as markers of short-term mortality in intensive care patients
- PMID: 31981636
- DOI: 10.1016/j.jinf.2020.01.010
Complement related pattern recognition molecules as markers of short-term mortality in intensive care patients
Abstract
Objectives: To evaluate the complement related pattern recognition molecules (PRMs) PTX3, MBL, CL-11, ficolin-2 and -3, along with the established marker CRP, to predict 28-day mortality and disease severity of sepsis in patients admitted to the intensive care unit (ICU).
Methods: In a single-center, prospective, observational study 547 patients were included over a period of 18 months. Blood samples were obtained at admission to the ICU and the following 4 days.
Results: PTX3 baseline levels were significantly higher in non-survivors compared to survivors, whereas MBL and ficolin-2 levels were significantly lower in non-survivors compared to survivors. A PTX3 level above the median was independently associated with 28-day mortality in the adjusted analysis including age, sex, chronic disease and immunosuppression (HR 1.87, 95% CI [1.41-2.48], p < 0.0001), while a MBL level above the median was associated with increased chance of survival (HR 0.75, 95% CI [0.57-0.98], p = 0.034). Ficolin-2 was only borderline significant (HR 0.79, 95% CI [0.60-1.03], p = 0.084). In a ROC analysis PTX3 was superior to CRP in predicting septic shock.
Conclusions: PTX3, MBL and CRP levels were independently associated with 28-day mortality in ICU patients. PTX3 was a better marker of septic shock compared to CRP.
Keywords: Collectin-11; Complement system; Ficolins; Mannose-binding lectin; PTX3; Sepsis.
Copyright © 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
Conflict of interest statement
Declaration of Competing Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Comment in
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Pentraxin 3: Potential prognostic role in SARS-CoV-2 patients admitted to the emergency department.J Infect. 2021 Apr;82(4):84-123. doi: 10.1016/j.jinf.2020.10.027. Epub 2020 Nov 2. J Infect. 2021. PMID: 33147434 Free PMC article. No abstract available.
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