Pancreatic stone protein as an early biomarker predicting mortality in a prospective cohort of patients with sepsis requiring ICU management 英文参考文献.docVIP

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Pancreatic stone protein as an early biomarker predicting mortality in a prospective cohort of patients with sepsis requiring ICU management 英文参考文献.doc

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Pancreatic stone protein as an early biomarker predicting mortality in a prospective cohort of patients with sepsis requiring ICU management 英文参考文献

Queetal.CriticalCare2012,16:R114 /content/16/4/R114 RESEARCH OpenAccess Pancreaticstoneproteinasanearlybiomarker predictingmortalityinaprospectivecohortof patientswithsepsisrequiringICUmanagement Yok-AiQue1,FrederikDelodder1,IdrisGuessous2,3,RolfGraf4,MarthaBain4,ThierryCalandra5,LucasLiaudet1and PhilippeEggimann1* Abstract Introduction:Biomarkers,suchasC-reactiveprotein[CRP]andprocalcitonin[PCT],areinsufficientlysensitiveor specifictostratifypatientswithsepsis.Weinvestigatetheprognosticvalueofpancreaticstoneprotein/ regeneratingprotein(PSP/reg)concentrationinpatientswithsevereinfections. Methods:PSP/reg,CRP,PCT,tumornecrosisfactor-alpha(TNF-a),interleukin1beta(IL1-b),IL-6andIL-8were prospectivelymeasuredincohortofpatients≥18yearsofagewithseveresepsisorsepticshockwithin24hours ofadmissioninamedico-surgicalintensivecareunit(ICU)ofacommunityandreferraluniversityhospital,andthe abilitytopredictin-hospitalmortalitywasdetermined. Results:Weevaluated107patients,33withseveresepsisand74withsepticshock,within-hospitalmortalityrates of6%(2/33)and25%(17/74),respectively.PlasmaconcentrationsofPSP/reg(343.5vs.73.5ng/ml,P0.001),PCT (39.3vs.12.0ng/ml,P0.001),IL-8(682vs.184ng/ml,P0.001)andIL-6(1955vs.544pg/ml,P0.01)were significantlyhigherinpatientswithsepticshockthanwithseveresepsis.Ofnote,medianPSP/regwas13.0ng/ml (IQR:4.8)in20severelyburnedpatientswithoutinfection.TheareaundertheROCcurveforPSP/reg(0.65[95%CI: 0.51to0.80])washigherthanforCRP(0.44[0.29to0.60]),PCT0.46[0.29to0.61]),IL-8(0.61[0.43to0.77])orIL-6 (0.59[0.44to0.75])inpredictingin-hospitalmortality.Inpatientswithsepticshock,PSP/regwastheonlybiomarker associatedwithin-hospitalmortality(P=0.049).Riskofmortalityincreasedcontinuouslyforeachascending quartileofPSP/reg. Conclusions:MeasurementofPSP/regconcentrationwithin24hoursofICUadmissionmaypredictin-hospital mortalityinpatientswithsepticshock,identifyingpatientswhomaybenefitmostfromtailoredICUmanagement. Introduction the heterogeneity of both microbial agents and host D