Objective: We previously demonstrated that plasma levels of F-actin and Thymosin Beta 4 differs among patients with septic shock, non-infectious systemic inflammatory syndrome and healthy controls and may serve as biomarkers for the diagnosis of sepsis. The current study aims to determine if these proteins are associated with or predictive of illness severity in patients at risk for sepsis in the Emergency Department (ED).

Methods: Prospective, biomarker study enrolling patients (>18 years) who met the Shock Precautions on Triage Sepsis rule placing them at-risk for sepsis.

Results: In this study of 203 ED patients, F-actin plasma levels had a linear trend of increase when the quick Sequential Organ Failure Assessment (qSOFA) score increased. F-actin was also increased in patients who were admitted to the Intensive Care Unit (ICU) from the ED, and in those with positive urine cultures. Thymosin Beta 4 was not associated with or predictive of any significant outcome measures.

Conclusion: Increased levels of plasma F-actin measured in the ED were associated with incremental illness severity as measured by the qSOFA score and need for ICU admission. F-actin may have utility in risk stratification of undifferentiated patients in the ED presenting with signs and symptoms of sepsis.

目的：我们以前证明了败血性休克，非感染性系统性炎症综合征和健康对照患者的血浆F-肌动蛋白和胸腺素β4有所不同，并且可以作为败血症诊断的生物标志物。当前的研究旨在确定这些蛋白质是否与急诊室（ED）有败血症风险的患者的疾病严重程度相关或预示其严重程度。

方法：前瞻性，生物标志物研究招募了符合“分类脓毒症休克注意事项”规则的患者（> 18岁），使他们有败血症危险。

结果：在这项针对203名ED患者的研究中，当快速序贯器官衰竭评估（qSOFA）评分增加时，F-肌动蛋白血浆水平呈线性增加趋势。从ED进入重症监护病房（ICU）的患者以及尿培养阳性的患者中的F-肌动蛋白也增加了。胸腺素Beta 4与任何重要的结局指标均无关联或无法预测。

结论：急诊室中血浆F-肌动蛋白水平的升高与疾病严重程度的增加有关，通过qSOFA评分和需要ICU入院来衡量。F-肌动蛋白可用于急诊中未表现出败血症症状的未分化患者的危险分层。