Prognostic value of plasma pentraxin 3 levels in patients with septic shock admitted to intensive care

Abstract

Objective To evaluate the usefulness of a new marker, pentraxin, as a prognostic marker in septic shock patients. Materials and methods Single-centre prospective observational study that included all consecutive patients 18 years or older who were admitted to the intensive care unit (ICU) with septic shock. Serum levels of procalcitonin (PCT), C-reactive protein (CRP) and pentraxin (PTX3) were measured on ICU admission. Results Seventy-five septic shock patients were included in the study. The best predictors of in-hospital mortality were the severity scores: SAPS II (AUC = 0.81), SOFA (AUC = 0.79) and APACHE II (AUC = 0.73). The ROC curve for PTX3 (ng/mL) yielded an AUC of 0.70, higher than the AUC for PCT (0.43) and CRP (0.48), but lower than lactate (0.79). Adding PTX3 to the logistic model increased the predictive capacity in relation to SAPS II, SOFA and APACHE II for in-hospital mortality (AUC 0.814, 0.795, and 0.741, respectively). In crude regression models, significant associations were found between in-hospital mortality and PTX3. This positive association increased after adjusting for age, sex and immunosuppression: adjusted OR T3 for PTX3 = 7.83, 95% CI 1.35–45.49, linear P trend = 0.024. Conclusion Our results support the prognostic value of a single determination of plasma PTX3 as a predictor of hospital mortality in septic shock patients.

Pentraxin-3 Is a Strong Biomarker of Sepsis Severity Identification and Predictor of 90-Day Mortality in Intensive Care Units via Sepsis 3.0 Definitions

“…Our results are consistent with previous studies that confirmed PTX3 as a prognostic biomarker for sepsis [16][17][18][19][20][21]. Higher levels of PTX3 were seen in non-survivors compared to survivors and were linked with the severity of sepsis.…”

“…It is involved in the defense of specific pathogens and regulation of inflammatory responses [14,15]. Recently, studies suggest that PTX3, along with other biomarkers (such as Interleukin-6 (IL-6), PCT, troponin T, monocyte chemoattractant protein 1 (MCP), proadrenomedullin (proADM), or angiopoietin (Ang) 1/2)) are closely relevant to the severity of patients with sepsis and septic shock and outcome prediction of sepsis and may be a potential biomarker of disease stratification [16][17][18][19][20][21][22].…”

<br/> INTERVENÇÕES ESPECIALIZADAS À PESSOA EM SITUAÇÃO CRÍTICA EM CHOQUE SÉPTICO: REVISÃO SISTEMÁTICA DA LITERATURA <br/>

“…Martin et al (10) referem no seu estudo que os lactatos são biomarcadores de lesão tecidular e que são ainda mais importantes perante o diagnóstico de pacientes em choque séptico, sem disfunção orgânica. Estes, identificaram que a lactacidémia > 2 mmol/L se apresentava como um dos indicadores de choque e que, quando presente, está associada a maior taxa de mortalidade dos pacientes.…”

Pentraxin-3 as a predictive marker of mortality in sepsis: an updated systematic review and meta-analysis

“…The meta-analysis by Lee et al showed that the elevated level of PTX3 was associated with an increased risk of patient mortality with sepsis [ 10 ]. More recently, several related studies have been published [ 9 – 14 ]. We aimed to provide an updated meta-analysis to further understand the predictive value of PTX3 in sepsis-related mortality.…”

“…As a key component of the human innate immune system, it plays an important role in the regulation of inflammation. In recent years, PTX3 has emerged as a promising biomarker for sepsis [ 9 ]. It has been demonstrated that the level of PTX3 is elevated in patients with sepsis.…”