Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Jan 14;11(1):1275.
doi: 10.1038/s41598-020-79843-5.

Mortality prediction using a novel combination of biomarkers in the first day of sepsis in intensive care units

Junkun Liu  1 , Chengwen Bai #  2 , Binbin Li #  2 , Aijun Shan  3 , Fei Shi  4 , Can Yao  2 , Yu Zhang  2 , Jin Wang  2 , Weibu Chen  5 , Manying Xie  2 , Dehui Deng  5
Affiliations
Observational Study

Mortality prediction using a novel combination of biomarkers in the first day of sepsis in intensive care units

Junkun Liu et al. Sci Rep. .

Abstract

Early identification of infection severity and organ dysfunction is crucial in improving outcomes of patients with sepsis. We aimed to develop a new combination of blood-based biomarkers that can early predict 28-day mortality in patients with sepsis or septic shock. We enrolled 66 patients with sepsis or septic shock and compared 14 blood-based biomarkers in the first 24 h after ICU admission. The serum levels of interleukin-6 (IL-6) (median 217.6 vs. 4809.0 pg/ml, P = 0.001), lactate (median 2.4 vs. 6.3 mmol/L, P = 0.014), N-terminal prohormone of brain natriuretic peptide (NT-proBNP) (median 1596.5 vs. 32,905.3 ng/ml, P < 0.001), prothrombin time (PT) (median 15.6 vs. 20.1 s, P = 0.030), activated partial thrombin time (APTT) (median 45.1 vs. 59.0 s, P = 0.026), and international normalized ratio (INR) (median 1.3 vs. 1.8, P < 0.001) were significantly lower in the survivor group. IL-6, NT-proBNP, and INR provided the best individual performance in predicting 28-day mortality of patients with sepsis or septic shock. Furthermore, the combination of these three biomarkers achieved better predictive performance (AUC 0.890, P < 0.001) than conventional scoring systems. In summary, the combination of IL-6, NT-proBNP, and INR may serve as a potential predictor of 28-day mortality in critically ill patients with sepsis or septic shock.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Screening and enrollment of the study.
Figure 2
Figure 2
The receiver operating characteristic (ROC) curves of the selected biomarkers for predicting 28-day mortality of critically ill patients with sepsis or septic shock. The ROC curves for single biomarker and their combinations had the following areas: interleukin-6 (IL-6), 0.785; international normalized ratio (INR), 0.748; N-terminal pro-brain natriuretic peptide (NT-proBNP), 0.825; combination of IL-6 and NT-proBNP, 0.879; and combination of IL-6, INR and NT-proBNP, 0.890.
Figure 3
Figure 3
Correlation analysis of biomarkers in all subjects. (A) Correlation between APACHE II and SOFA, (B) Correlation between IL-6 and APACHE II, (C) Correlation between IL-6 and SOFA, (D) Correlation between NT-proBNP and APACHE II, (E) Correlation between NT-proBNP and SOFA, (F) Correlation between INR and APACHE II, and (G) Correlation between INR and SOFA.
See this image and copyright information in PMC

References

    1. Rhodes A, et al. Surviving sepsis campaign: International guidelines for management of sepsis and septic shock: 2016. Crit. Care Med. 2017;45:486–552. doi: 10.1097/CCM.0000000000002255. - DOI - PubMed
    1. Luhr R, Cao Y, Söderquist B, Cajander S. Trends in sepsis mortality over time in randomised sepsis trials: A systematic literature review and meta-analysis of mortality in the control arm, 2002–2016. Crit. Care. 2019;23:241. doi: 10.1186/s13054-019-2528-0. - DOI - PMC - PubMed
    1. Liu Y, Han N, Li Q, Li Z. Regulatory mechanisms underlying sepsis progression in patients with tumor necrosis factor-alpha genetic variations. Exp. Ther. Med. 2016;12:323–328. doi: 10.3892/etm.2016.3308. - DOI - PMC - PubMed
    1. Costa RT, et al. T helper type cytokines in sepsis: Time-shared variance and correlation with organ dysfunction and hospital mortality. Braz. J. Infect. Dis. 2019;23:79–85. doi: 10.1016/j.bjid.2019.04.008. - DOI - PMC - PubMed
    1. Guarracino F, Bertini P, Pinsky MR. Cardiovascular determinants of resuscitation from sepsis and septic shock. Crit. Care. 2019;23:118. doi: 10.1186/s13054-019-2414-9. - DOI - PMC - PubMed

Publication types