Department of Medical Intensive Care Unit, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
Correspondence
Corresponding author. Department of Medical Intensive Care Unit, The First Affiliated Hospital, Sun Yat-Sen University, 58# Zhongshan 2nd Road, Guangzhou, 510080, China.
Department of Medical Intensive Care Unit, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
Correspondence
Corresponding author. Department of Medical Intensive Care Unit, The First Affiliated Hospital, Sun Yat-Sen University, 58# Zhongshan 2nd Road, Guangzhou, 510080, China.
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Figures
Figure
A, Receiver operating characteristics of suPAR, PCT and CRP in distinguishing sepsis from SIRS. B, Receiver operating characteristics of suPAR, PCT and suPAR combined with PCT in distinguishing sepsis from SIRS. C, Daily variations of plasma suPAR levels between survivors and non-survivors in sepsis. D, Daily variations of serum PCT levels between survivors and non-survivors in sepsis. E, ROC curve of suPAR, PCT, Lac, APACHE II score and SOFA score in predicting mortality in sepsis. F, ROC curve of suPAR, APACHE II score and suPAR, combined with APACHE II score in predicting mortality in sepsis.
Abstract
Objectives
The level of soluble urokinase-type plasminogen activator receptor (suPAR) is significantly increased in sepsis. We investigated whether suPAR could be a valuable biomarker in sepsis.
Methods
We measured suPAR and procalcitonin (PCT) levels, recorded the Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment scores of engaged subjects, and drew Receiver Operating Characteristics curves.
Results
The plasma suPAR and serum PCT levels of the sepsis group were higher than those of the systemic inflammatory response syndrome and control groups. Using suPAR to distinguish systemic inflammatory response syndrome from sepsis on day 1, the area under the curve (AUC) curve was 0.817, and when suPAR and PCT were used in combination to diagnose sepsis, the AUC was 0.927. At a cutoff point of 9.52 ng/mL, the sensitivity and specificity for diagnosis of sepsis using suPAR were 71.93% and 95.46%, respectively. At a cutoff point of 12.01 ng/mL, the sensitivity and specificity for distinguishing survival and mortality by suPAR were 87.1% and 72.5%, respectively. When suPAR and the APACHE II score were combined to distinguish survival from mortality, the AUC was 0.857. The plasma suPAR level was positively correlated with the serum PCT level (r = 0.326, P < .001), APACHE II score (r = 0.492, P < .001), and Sequential Organ Failure Assessment score (r = 0.386, P < .001).
Conclusions
Use of both plasma suPAR and PCT levels enhanced the efficiency of sepsis diagnosis, and the combination of plasma suPAR and APACHE II score improved mortality prediction.
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