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Evaluation of sTREM1 and suPAR Biomarkers as Diagnostic and Prognostic Predictors in Sepsis Patients
Infection and Drug Resistance ( IF 3.9 ) Pub Date : 2021-08-31 , DOI: 10.2147/idr.s314237 Asmaa Nasr El-Din 1 , Abdelhady Ragab Abdel-Gawad 2 , Wesam Abdelgalil 3 , Nahed F Fahmy 1
Infection and Drug Resistance ( IF 3.9 ) Pub Date : 2021-08-31 , DOI: 10.2147/idr.s314237 Asmaa Nasr El-Din 1 , Abdelhady Ragab Abdel-Gawad 2 , Wesam Abdelgalil 3 , Nahed F Fahmy 1
Affiliation
Background: The purpose of this study was to explore the diagnostic role of sTREM1 in the diagnosis of sepsis and in differentiating between sepsis and systemic inflammatory response syndrome (SIRS). We also aimed to assess the prognostic value of suPAR in comparison to sequential organ-failure assessment (SOFA), acute physiology and chronic health evaluation (APACHE) II scores, and 28-day mortality.
Methods: This was a cross-sectional study conducted in the Medical Microbiology and Immunology Department and Central Research Laboratory, Faculty of Medicine, Sohag University from June 2019 to January 2021. The study population was classified into two groups: SIRS (no evidence of infection) and sepsis (with SIRS and evidence of infection). Patients were rated on the SOFA and APACHE II scoring systems at admission and after 7 days. Serum levels of sTREM1 and suPAR were measured by ELISA at the same time points.
Results: CRP and sTREM1 values were significantly higher in the sepsis group than the SIRS group on both days (P< 0.0001). The area under the curve (AUC) for CRP was 0.87 on the first day and 0.97 on the seventh, while the AUC for sTREM1 was 1.00 and 0.93 on the first and seventh days, respectively. The sensitivity of sTREM1 was 100% and specificity 84% at a cutoff of 49 pg/mL. There was a significantly positive correlation between CRP and sTREM1 values (P< 0.0001). On the seventh day, nonsurvivors had significantly higher serum levels of suPAR (median 4.9 ng/mL) than survivors (median 2.9 ng/mL; P< 0.0001). Nonsurvivors also had significantly higher SOFA and APACHE II scores than survivors (P< 0.0001 and P< 0.0001, respectively).
Conclusion: sTREM1 can be used as a good indicator for diagnosing sepsis in intensive care–unit patients. suPAR can also be used as a predictor of bad prognosis and poor survival at 7 days following admission.
中文翻译：
评估 sTREM1 和 suPAR 生物标志物作为脓毒症患者的诊断和预后预测指标
背景：本研究的目的是探讨 sTREM1 在诊断脓毒症以及区分脓毒症和全身炎症反应综合征 (SIRS) 中的诊断作用。我们还旨在评估 suPAR 与序贯器官衰竭评估 (SOFA)、急性生理学和慢性健康评估 (APACHE) II 评分以及 28 天死亡率相比的预后价值。
方法：这是一项横断面研究，于 2019 年 6 月至 2021 年 1 月在 Sohag 大学医学院医学微生物学和免疫学系和中央研究实验室进行。研究人群分为两组：SIRS（无感染证据）和败血症（有 SIRS 和感染证据）。患者在入院时和 7 天后在 SOFA 和 APACHE II 评分系统上进行评分。在同一时间点通过ELISA测量血清sTREM1和suPAR水平。
结果：脓毒症组 CRP 和 sTREM1 值均显着高于 SIRS 组（P< 0.0001)。CRP 的曲线下面积 (AUC) 第一天为 0.87，第七天为 0.97，而 sTREM1 的曲线下面积 (AUC) 在第一天和第七天分别为 1.00 和 0.93。sTREM1 的灵敏度为 100%，特异性为 84%，截止值为 49 pg/mL。CRP与sTREM1值呈显着正相关（P <0.0001）。第 7 天，非幸存者的 suPAR 血清水平（中位数 4.9 ng/mL）显着高于幸存者（中位数 2.9 ng/mL；P < 0.0001）。非幸存者的 SOFA 和 APACHE II 评分也显着高于幸存者（分别为P < 0.0001 和P < 0.0001）。
结论：sTREM1 可作为诊断重症监护病房患者败血症的良好指标。suPAR 也可用作入院后 7 天不良预后和不良生存率的预测指标。
更新日期：2021-08-30
Methods: This was a cross-sectional study conducted in the Medical Microbiology and Immunology Department and Central Research Laboratory, Faculty of Medicine, Sohag University from June 2019 to January 2021. The study population was classified into two groups: SIRS (no evidence of infection) and sepsis (with SIRS and evidence of infection). Patients were rated on the SOFA and APACHE II scoring systems at admission and after 7 days. Serum levels of sTREM1 and suPAR were measured by ELISA at the same time points.
Results: CRP and sTREM1 values were significantly higher in the sepsis group than the SIRS group on both days (P< 0.0001). The area under the curve (AUC) for CRP was 0.87 on the first day and 0.97 on the seventh, while the AUC for sTREM1 was 1.00 and 0.93 on the first and seventh days, respectively. The sensitivity of sTREM1 was 100% and specificity 84% at a cutoff of 49 pg/mL. There was a significantly positive correlation between CRP and sTREM1 values (P< 0.0001). On the seventh day, nonsurvivors had significantly higher serum levels of suPAR (median 4.9 ng/mL) than survivors (median 2.9 ng/mL; P< 0.0001). Nonsurvivors also had significantly higher SOFA and APACHE II scores than survivors (P< 0.0001 and P< 0.0001, respectively).
Conclusion: sTREM1 can be used as a good indicator for diagnosing sepsis in intensive care–unit patients. suPAR can also be used as a predictor of bad prognosis and poor survival at 7 days following admission.
中文翻译：
评估 sTREM1 和 suPAR 生物标志物作为脓毒症患者的诊断和预后预测指标
背景：本研究的目的是探讨 sTREM1 在诊断脓毒症以及区分脓毒症和全身炎症反应综合征 (SIRS) 中的诊断作用。我们还旨在评估 suPAR 与序贯器官衰竭评估 (SOFA)、急性生理学和慢性健康评估 (APACHE) II 评分以及 28 天死亡率相比的预后价值。
方法：这是一项横断面研究，于 2019 年 6 月至 2021 年 1 月在 Sohag 大学医学院医学微生物学和免疫学系和中央研究实验室进行。研究人群分为两组：SIRS（无感染证据）和败血症（有 SIRS 和感染证据）。患者在入院时和 7 天后在 SOFA 和 APACHE II 评分系统上进行评分。在同一时间点通过ELISA测量血清sTREM1和suPAR水平。
结果：脓毒症组 CRP 和 sTREM1 值均显着高于 SIRS 组（P< 0.0001)。CRP 的曲线下面积 (AUC) 第一天为 0.87，第七天为 0.97，而 sTREM1 的曲线下面积 (AUC) 在第一天和第七天分别为 1.00 和 0.93。sTREM1 的灵敏度为 100%，特异性为 84%，截止值为 49 pg/mL。CRP与sTREM1值呈显着正相关（P <0.0001）。第 7 天，非幸存者的 suPAR 血清水平（中位数 4.9 ng/mL）显着高于幸存者（中位数 2.9 ng/mL；P < 0.0001）。非幸存者的 SOFA 和 APACHE II 评分也显着高于幸存者（分别为P < 0.0001 和P < 0.0001）。
结论：sTREM1 可作为诊断重症监护病房患者败血症的良好指标。suPAR 也可用作入院后 7 天不良预后和不良生存率的预测指标。
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