Complement related pattern recognition molecules as markers of short-term mortality in intensive care patients - 20/03/20
, Rafael Bayarri-Olmos a, Markus K. Kristensen a, Katrine Pilely a, Dorthe Hellemann b, Peter Garred aHighlights |
• | Comprehensive overview of complement related pattern recognition molecules (PRMs) in ICU patients. |
• | Time dependent analysis of plasma PRM levels during ICU stay. |
• | High PTX3 and CRP levels were independently associated with increased 28-day mortality. |
• | A high MBL level was independently associated with improved chance of survival. |
• | PTX3 appears to be a superior marker of septic shock compared to CRP. |
Summary |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Sepsis, Complement system, Ficolins, Mannose-binding lectin, Collectin-11, PTX3
Abbreviations : AUC, CI, CL-10, CL-11, CRP, ELISA, HR, ICU, IQR, MASP, MBL, PRM, PTX3, ROC, SAPS II, SIRS, SOFA
Plan
Vol 80 - N° 4
P. 378-387 - avril 2020 Retour au numéro
Article précédent
- Coronavirus 2019-nCoV: A brief perspective from the front line
- Qingmei Han, Qingqing Lin, Shenhe Jin, Liangshun You
- Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China
- Wenjie Yang, Qiqi Cao, Le Qin, Xiaoyang Wang, Zenghui Cheng, Ashan Pan, Jianyi Dai, Qingfeng Sun, Fengquan Zhao, Jieming Qu, Fuhua Yan
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?