4d32b3dc8ae9fa7a6fdcdf054a04c166 pmc_10452503.pdf 828f82291253a97732f2385d13f7cb42152713c6 pmc_10452503.pdf a2c9e565e637771cc499003edfd9332db07de078b7aa1b459d4555f7ba6a3063 pmc_10452503.pdf Title: Use of Biomarkers to Improve 28-Day Mortality Stratification in Patients with Sepsis and SOFA 6 Subject: Early diagnosis and appropriate treatments are crucial to reducing mortality risk in septic patients. Low SOFA scores and current biomarkers may not adequately discern patients that could develop severe organ dysfunction or have an elevated mortality risk. The aim of this prospective observational study was to evaluate the predictive value of the biomarkers mid-regional pro-adrenomedullin (MR-proADM), procalcitonin (PCT), C-reactive protein (CRP), and lactate for 28-day mortality in patients with sepsis, and patients with a SOFA score 6. 284 were included, with a 28-day all-cause mortality of 8.45% (n = 24). Non-survivors were older (p = 0.003), required mechanical ventilation (p = 0.04), were ventilated for longer (p = 0.02), and had higher APACHE II (p = 0.015) and SOFA (p = 0.027) scores. Lactate showed the highest predictive ability for all-cause 28-day mortality, with an area under the receiver-operating characteristic curve (AUROC) of 0.67 (0.55–0.79). The AUROC for all-cause 28-day mortality in patients with community-acquired infection was 0.69 (0.57–0.84) for SOFA and 0.70 (0.58–0.82) for MR-proADM. A 2.1 nmol/L cut-off point for this biomarker in this subgroup of patients discerned, with 100% sensibility, survivors from non-survivors at 28 days. In patients with community-acquired sepsis and initial SOFA score 6, MR-proADM could help identify patients at risk of 28-day mortality. Keywords: sepsis biomarkers; mortality; MR-proADM; SOFA score; lactate; molecular diagnosis Author: Jaume Baldirà, Juan Carlos Ruiz-Rodríguez, Adolfo Ruiz-Sanmartin, Luis Chiscano, Alejandro Cortes, Diego Ángeles Sistac, Roser Ferrer-Costa, Inma Comas, Yolanda Villena, Maria Nieves Larrosa, Juan José González-López and Ricard Ferrer Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Sun Jul 30 10:30:11 2023 CEST ModDate: Sun Jul 30 10:32:06 2023 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1683328 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- YRKSID+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 OHKNFJ+VnURWPalladioL Type 1 Custom yes yes no 15 0 HUXSMC+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 HTADPD+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 RQPVQI+CMSY10 Type 1 Builtin yes yes no 28 0 ODIXRQ+URWPalladioL-Ital Type 1 Custom yes yes no 32 0 TTFQJI+CMBSY10 Type 1 Builtin yes yes no 36 0 EBFBTV+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 54 0 AMJFPI+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 86 0 AMJANA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 89 0 AMJANB+PalatinoLinotype CID TrueType Identity-H yes yes yes 92 0 AMJANC+PalatinoLinotype TrueType WinAnsi yes yes no 98 0 AMJANE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 101 0 AMJDJF+PalatinoLinotype TrueType MacRoman yes yes no 104 0 MOSBKF+URWPalladioL-BoldItal Type 1 Custom yes yes no 115 0 AMJANA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 125 0 AMJANC+PalatinoLinotype TrueType WinAnsi yes yes no 128 0 AMJAND+PalatinoLinotype,Italic CID TrueType Identity-H yes yes yes 131 0 AMJANE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 137 0 AMJANA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 147 0 AMJANC+PalatinoLinotype TrueType WinAnsi yes yes no 150 0 AMJAND+PalatinoLinotype,Italic CID TrueType Identity-H yes yes yes 153 0 AMJANE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 159 0 AMJANA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 178 0 AMJANB+PalatinoLinotype CID TrueType Identity-H yes yes yes 181 0 AMJANC+PalatinoLinotype TrueType WinAnsi yes yes no 187 0 AMJAND+PalatinoLinotype,Italic CID TrueType Identity-H yes yes yes 190 0 AMJANE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 196 0 AMJDJF+PalatinoLinotype TrueType MacRoman yes yes no 199 0 AMJANA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 217 0 AMJANB+PalatinoLinotype CID TrueType Identity-H yes yes yes 220 0 AMJANC+PalatinoLinotype TrueType WinAnsi yes yes no 226 0 AMJAND+PalatinoLinotype,Italic CID TrueType Identity-H yes yes yes 229 0 AMJANE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 235 0 AMJDJF+PalatinoLinotype TrueType MacRoman yes yes no 238 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-05-07 02:39:04 CEST RepresentationInformation: pmc_10452503.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-04-24 02:39:56 CEST Size: 1683328 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 398 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: Study Design Destination: subsection.2.1 Item: Title: Setting and Participants Destination: subsection.2.2 Item: Title: Variables and Data Sources Destination: subsection.2.3 Item: Title: Statistical Methods Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Participant Characteristics Destination: subsection.3.1 Item: Title: Biomarker Predictive Ability in Patients with Sepsis and a SOFA Score 6 Destination: subsection.3.2 Item: Title: Inter-Biomarker Associations and 28-Day Survival Analysis in Patients with Sepsis and a SOFA Score 6 Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Use of Biomarkers to Improve 28-Day Mortality Stratification in Patients with Sepsis and SOFA 6 Author: Jaume Baldirà, Juan Carlos Ruiz-Rodríguez, Adolfo Ruiz-Sanmartin, Luis Chiscano, Alejandro Cortes, Diego Ángeles Sistac, Roser Ferrer-Costa, Inma Comas, Yolanda Villena, Maria Nieves Larrosa, Juan José González-López and Ricard Ferrer Subject: Early diagnosis and appropriate treatments are crucial to reducing mortality risk in septic patients. Low SOFA scores and current biomarkers may not adequately discern patients that could develop severe organ dysfunction or have an elevated mortality risk. The aim of this prospective observational study was to evaluate the predictive value of the biomarkers mid-regional pro-adrenomedullin (MR-proADM), procalcitonin (PCT), C-reactive protein (CRP), and lactate for 28-day mortality in patients with sepsis, and patients with a SOFA score 6. 284 were included, with a 28-day all-cause mortality of 8.45% (n = 24). Non-survivors were older (p = 0.003), required mechanical ventilation (p = 0.04), were ventilated for longer (p = 0.02), and had higher APACHE II (p = 0.015) and SOFA (p = 0.027) scores. Lactate showed the highest predictive ability for all-cause 28-day mortality, with an area under the receiver-operating characteristic curve (AUROC) of 0.67 (0.55 0.79). The AUROC for all-cause 28-day mortality in patients with community-acquired infection was 0.69 (0.57 0.84) for SOFA and 0.70 (0.58 0.82) for MR-proADM. A 2.1 nmol/L cut-off point for this biomarker in this subgroup of patients discerned, with 100% sensibility, survivors from non-survivors at 28 days. In patients with community-acquired sepsis and initial SOFA score 6, MR-proADM could help identify patients at risk of 28-day mortality. 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