Significance of soluble triggering receptor expressed on myeloid cells-1 elevation in patients admitted to the intensive care unit with sepsis.
Significance of soluble triggering receptor expressed on myeloid cells-1 elevation in patients admitted to the intensive care unit with sepsis.
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DOI：
10.1186/s12879-016-1893-4
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发表时间：
2016-10-12
影响因子：
3.7
通讯作者：
Gibot S
中科院分区：
文献类型：
--
作者：
Charles PE;Noel R;Massin F;Guy J;Bollaert PE;Quenot JP;Gibot S
在入住重症监护室（ICU）的脓毒症患者中，早期识别死亡风险最高的患者至关重要。由于临床判断有时是不确定的，生物标志物可以提供可能指导危重病管理的额外信息。我们评估了髓样细胞表达的可溶性触发受体1（斯特雷姆-1）、降钙素原（PCT）和白细胞表面CD 64表达的预后价值。这是一项前瞻性队列研究，纳入了两家医院ICU收治的190例脓毒症患者。在入院时和之后获得用于生物标志物测量的血液样品。计算简化急性生理学评分（SAPS）II和序贯器官衰竭评估（SOFA）评分。主要结局是ICU中的全因死亡。死亡率达25.8%。使用基线斯特雷姆-1获得三种生物标志物的最佳预测值，尽管临床评分优于此。准确性更高的患者没有事先暴露于抗生素，并在那些证实细菌感染。将斯特雷姆-1水平添加到SAPS II中将其特异性提高到98%。在校正潜在混杂因素后，可溶性TREM-1水平、核心温度和SAPS II值是死亡的唯一独立预测因素。斯特雷姆-1随时间的减少在幸存者中也比非幸存者更明显。发现斯特雷姆-1是测试的那些中最好的预后生物标志物。基线值和随时间的变化似乎都具有相关性。尽管SAPS II在预测ICU生存率方面优于斯特雷姆-1，但该生物标志物可提供额外信息。本文的在线版本（doi：10.1186/s12879-016-1893-4）包含补充材料，可供授权用户使用。
Among septic patients admitted to the intensive care unit (ICU), early recognition of those with the highest risk of death is of paramount importance. Since clinical judgment is sometimes uncertain biomarkers could provide additional information likely to guide critical illness management. We evaluated the prognostic value of soluble Triggering Receptor Expressed by Myeloid cells 1 (sTREM-1), procalcitonin (PCT) and leucocyte surface expression of CD64. This was a prospective cohort study, which included 190 septic patient admitted to the ICU in two hospitals. Blood samples for biomarker measurements were obtained upon admission and thereafter. The Simplified Acute Physiology Score (SAPS) II and the Sequential Organ Failure Assessment (SOFA) score were calculated. The primary outcome was all-cause death in the ICU. The mortality rate reached 25.8 %. The best predictive value of the three biomarkers was obtained with baseline sTREM-1, although clinical scores outperformed this. Accuracy was greater in patients without prior exposure to antibiotics and in those with proven bacterial infection. Adding sTREM-1 levels to SAPS II increased its specificity to 98 %. The soluble TREM-1 level, core temperature and SAPS II value were the only independent predictors of death after adjustment for potential confounders. A decrease in sTREM-1 with time was also more pronounced in survivors than in non-survivors. sTREM-1 was found to be the best prognostic biomarker among those tested. Both baseline values and variations with time seemed relevant. Although SAPS II outperformed sTREM-1 regarding the prediction of ICU survival, the biomarker could provide additional information. The online version of this article (doi:10.1186/s12879-016-1893-4) contains supplementary material, which is available to authorized users.
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影响因子：
38.9
作者：
Dellinger RP;Levy MM;Rhodes A;Annane D;Gerlach H;Opal SM;Sevransky JE;Sprung CL;Douglas IS;Jaeschke R;Osborn TM;Nunnally ME;Townsend SR;Reinhart K;Kleinpell RM;Angus DC;Deutschman CS;Machado FR;Rubenfeld GD;Webb S;Beale RJ;Vincent JL;Moreno R;Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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作者：
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