171a0bf330d5f9e52f6dc5f78d0b09f9 291133.pdf c4d9d927976a2195f1f4f453cb5caefcff5a8eb0 291133.pdf ddd4c9b9544001cda90c3ddbd6638f74bf27cb943c2dae6705c3da30b19db7a9 291133.pdf Title: HLA-DR Expression on Monocytes and Sepsis Index Are Useful in Predicting Sepsis Subject: The reduction of mortality in patients with sepsis depends on the early identification and treatment of at-risk patients. The aim was to evaluate the HLA-DR expression on the surface of monocytes (MHLA-DR ratio), the sepsis index (CD64 expression on neutrophils/MHLA-DR ratio), and C-reactive protein (CRP) with the development of sepsis. We prospectively enrolled 77 critically ill patients, 59 with stroke and 18 with traumatic brain injuries. The biomarkers were tested at the baseline and 3, 6, 9, 12, and 15 days later. Most patients (71%) developed sepsis (4.2 1.3 days after admission). On day 3, those subsequently developing sepsis had lower levels of MHLA-DR+ (81.7 16.2% vs. 88.5 12.1%, p < 0.05) and higher sepsis indexes (0.19 0.19 vs. 0.08 0.08, p < 0.01) than those not developing sepsis. The MHLA-DR ratio slowly recovered before day 6, while the sepsis index remained raised in septic patients up to day 9 (p < 0.05). To predict the development of sepsis, optimal cut-offs were CRP levels > 106.90 mg/mL (74.19% sensitivity, 69.49 specificity) and MHLA-DR expression rate < 72.80% (45.31% sensitivity, 89.47% specificity). The periodic monitoring of the MHLA-DR expression together with CRP and sepsis index may help to identify patients in the ICU at increased risk of developing sepsis. Keywords: sepsis; biomarker; sepsis index Author: Bibiana Quirant-Sánchez, Oriol Plans-Galván, Ester Lucas, Eduard Argudo, Eva María Martinez-Cáceres and Fernando Arméstar Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Jul 7 07:34:50 2023 CEST ModDate: Fri Jul 7 07:37:20 2023 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 10 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1741924 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- CIQLLF+VnURWPalladioL Type 1 Custom yes yes no 10 0 VHIDBS+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 OFUHIJ+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 EQGLAL+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 TAQQTO+CMSY10 Type 1 Builtin yes yes no 28 0 IOJCNK+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 EBFBTV+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 50 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 72 0 ZXDKIP+EURM10 Type 1 Builtin yes yes no 79 0 JHIDJM+Calibri CID TrueType Identity-H yes yes yes 93 0 JDFIFI+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 114 0 JDFIFK+PalatinoLinotype TrueType WinAnsi yes yes no 117 0 JDFIGM+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 120 0 JDFIFI+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 132 0 JDFIFK+PalatinoLinotype TrueType WinAnsi yes yes no 135 0 JDFIGM+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 138 0 JDFIFI+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 158 0 JDFIFK+PalatinoLinotype TrueType WinAnsi yes yes no 161 0 JDFIGM+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 164 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-05-01 02:42:47 CEST RepresentationInformation: 291133.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-04-30 11:00:49 CEST Size: 1741924 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 276 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Patients Destination: subsection.2.1 Item: Title: Definitions Destination: subsection.2.2 Item: Title: Samples Destination: subsection.2.3 Item: Title: Flow Cytometry Staining Destination: subsection.2.4 Item: Title: Flow Cytometry Calibration Destination: subsection.2.5 Item: Title: Flow Cytometry Analysis Destination: subsection.2.6 Item: Title: Plasma Analysis Destination: subsection.2.7 Item: Title: Statistical Analysis Destination: subsection.2.8 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: References Destination: section.A. Info: Title: HLA-DR Expression on Monocytes and Sepsis Index Are Useful in Predicting Sepsis Author: Bibiana Quirant-Sánchez, Oriol Plans-Galván, Ester Lucas, Eduard Argudo, Eva María Martinez-Cáceres and Fernando Arméstar Subject: The reduction of mortality in patients with sepsis depends on the early identification and treatment of at-risk patients. The aim was to evaluate the HLA-DR expression on the surface of monocytes (MHLA-DR ratio), the sepsis index (CD64 expression on neutrophils/MHLA-DR ratio), and C-reactive protein (CRP) with the development of sepsis. We prospectively enrolled 77 critically ill patients, 59 with stroke and 18 with traumatic brain injuries. The biomarkers were tested at the baseline and 3, 6, 9, 12, and 15 days later. Most patients (71%) developed sepsis (4.2 1.3 days after admission). On day 3, those subsequently developing sepsis had lower levels of MHLA-DR+ (81.7 16.2% vs. 88.5 12.1%, p < 0.05) and higher sepsis indexes (0.19 0.19 vs. 0.08 0.08, p < 0.01) than those not developing sepsis. The MHLA-DR ratio slowly recovered before day 6, while the sepsis index remained raised in septic patients up to day 9 (p < 0.05). To predict the development of sepsis, optimal cut-offs were CRP levels > 106.90 mg/mL (74.19% sensitivity, 69.49 specificity) and MHLA-DR expression rate < 72.80% (45.31% sensitivity, 89.47% specificity). The periodic monitoring of the MHLA-DR expression together with CRP and sepsis index may help to identify patients in the ICU at increased risk of developing sepsis. 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