ABSTRACT
Objectives: To evaluate the ability of at-admission (Day 1) estimated serum levels of inflammatory
biomarkers and clinical scorings for prediction of survival outcome of sepsis patients
admitted to surgical ICU.
Patients & Methods: One hundred and seventy-eight patients were clinically evaluated and
gave blood samples for estimation of serum biomarkers’ levels (Day 1 data) and re-evaluated
on Days 2–3 for the National Early Warning-2 (NEWS-2) score and Day 3 for the Sequential
organ failure assessment (SOFA) score and serum level of presepsin (PSP). During 28-day,
patients were grouped according to survival outcome as Survivors and Non-survivors.
Results: Day1 clinical scorings and biomarkers’ levels were significantly higher in non-survivors
(n = 41) than survivors (n = 137). Day 3 SOFA scores of all patients were significantly higher than
Day1 scores with significantly higher scores for non-survivors. Through Day1-3, the number of
patients with high-grade risk on NEWS2 was significantly higher among non-survivors. Day-3
serum PSP levels were significantly decreased in survivors, while increased in non-survivors.
The statistical analyses defined high NEWS2, SOFA, PSP, and procalcitonin serum levels as the
significant predictors of mortality. Diagnostic performance characteristics of combined NEWS
score and PSP showed high sensitivity, specificity, and accuracy rates with a 99% negative
predictive value for survival outcomes.
Conclusion: Sequential estimation of NEWS2 score and serum PSP can discriminate between
high-risk patients and those prone to die. Coupling of NEWS-2 scoring and estimation of serum
PSP allowed more accurate early identification of patients vulnerable to deterioration with high
sensitivity and accuracy rates. |
