Long pentraxin 3 as a predictive marker of mortality in severe septic patients who received successful early goal-directed therapy

Sun Bean Kim, Kyoung Hwa Lee, Ji Un Lee, Hea Won Ann, Jin Young Ahn, Yong Duk Jeon, Jung Ho Kim, Nam Su Ku, Sang Hoon Han, Jun Yong Choi, Young Goo Song, June Myung Kim

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose: Pentraxin 3 (PTX3) has been suggested to be a prognostic marker of mortality in severe sepsis. Currently, there are limited data on biomarkers including PTX3 that can be used to predict mortality in severe sepsis patients who have undergone successful initial resuscitation through early goal-directed therapy (EGDT). Materials and Methods: A prospective cohort study was conducted among 83 severe sepsis patients with fulfillment of all EGDT components and the achievement of final goal. Plasma PTX3 levels were measured by sandwich ELISA on hospital day (HD) 0, 3, and 7. The data for procalcitonin, C-reactive protein and delta neutrophil index were collected by electric medical record. The primary outcome was 28-day all-cause mortality. Results: 28-day all-cause mortality was 19.3% and the median (interquartile range) APHCH II score of total patients was 16 (13– 19). The non-survivors (n=16) had significantly higher PTX3 level at HD 0 [201.4 (56.9–268.6) ng/mL vs. 36.5 (13.7–145.3) ng/mL, p=0.008]. PTX3 had largest AUCROC value for the prediction of mortality among PTX3, procalcitonin, delta neutrophil index, CRP and APACHE II/SOFA sore at HD 0 [0.819, 95% confidence interval (CI) 0.677–0.961, p=0.008]. The most valid cut-off level of PTX3 at HD 0 was 140.28 ng/mL (sensitivity 66.7%, specificity 73.8%). The PTX3 and procalcitonin at HD 0 showed strong correlation (r=0.675, p<0.001). However, PTX3 at HD 0 was the only independent predictive marker in Cox’s proportional hazards model (≥140 ng/mL; hazard rate 7.16, 95% CI 2.46–15.85, p=0.001). Conclusion: PTX3 at HD 0 could be a powerful predictive biomarker of 28-day all-cause mortality in severe septic patients who have undergone successful EGDT.

Original languageEnglish
Pages (from-to)370-379
Number of pages10
JournalYonsei medical journal
Volume58
Issue number2
DOIs
Publication statusPublished - 2017 Mar

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Mortality
Calcitonin
Therapeutics
Sepsis
Neutrophils
Biomarkers
PTX3 protein
Confidence Intervals
APACHE
Proportional Hazards Models
Resuscitation
C-Reactive Protein
Medical Records
Cohort Studies
Enzyme-Linked Immunosorbent Assay
Prospective Studies
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Kim, Sun Bean ; Lee, Kyoung Hwa ; Lee, Ji Un ; Ann, Hea Won ; Ahn, Jin Young ; Jeon, Yong Duk ; Kim, Jung Ho ; Ku, Nam Su ; Han, Sang Hoon ; Choi, Jun Yong ; Song, Young Goo ; Kim, June Myung. / Long pentraxin 3 as a predictive marker of mortality in severe septic patients who received successful early goal-directed therapy. In: Yonsei medical journal. 2017 ; Vol. 58, No. 2. pp. 370-379.
@article{fea7c4b3f70348199e09506ff2c0e096,
title = "Long pentraxin 3 as a predictive marker of mortality in severe septic patients who received successful early goal-directed therapy",
abstract = "Purpose: Pentraxin 3 (PTX3) has been suggested to be a prognostic marker of mortality in severe sepsis. Currently, there are limited data on biomarkers including PTX3 that can be used to predict mortality in severe sepsis patients who have undergone successful initial resuscitation through early goal-directed therapy (EGDT). Materials and Methods: A prospective cohort study was conducted among 83 severe sepsis patients with fulfillment of all EGDT components and the achievement of final goal. Plasma PTX3 levels were measured by sandwich ELISA on hospital day (HD) 0, 3, and 7. The data for procalcitonin, C-reactive protein and delta neutrophil index were collected by electric medical record. The primary outcome was 28-day all-cause mortality. Results: 28-day all-cause mortality was 19.3{\%} and the median (interquartile range) APHCH II score of total patients was 16 (13– 19). The non-survivors (n=16) had significantly higher PTX3 level at HD 0 [201.4 (56.9–268.6) ng/mL vs. 36.5 (13.7–145.3) ng/mL, p=0.008]. PTX3 had largest AUCROC value for the prediction of mortality among PTX3, procalcitonin, delta neutrophil index, CRP and APACHE II/SOFA sore at HD 0 [0.819, 95{\%} confidence interval (CI) 0.677–0.961, p=0.008]. The most valid cut-off level of PTX3 at HD 0 was 140.28 ng/mL (sensitivity 66.7{\%}, specificity 73.8{\%}). The PTX3 and procalcitonin at HD 0 showed strong correlation (r=0.675, p<0.001). However, PTX3 at HD 0 was the only independent predictive marker in Cox’s proportional hazards model (≥140 ng/mL; hazard rate 7.16, 95{\%} CI 2.46–15.85, p=0.001). Conclusion: PTX3 at HD 0 could be a powerful predictive biomarker of 28-day all-cause mortality in severe septic patients who have undergone successful EGDT.",
author = "Kim, {Sun Bean} and Lee, {Kyoung Hwa} and Lee, {Ji Un} and Ann, {Hea Won} and Ahn, {Jin Young} and Jeon, {Yong Duk} and Kim, {Jung Ho} and Ku, {Nam Su} and Han, {Sang Hoon} and Choi, {Jun Yong} and Song, {Young Goo} and Kim, {June Myung}",
year = "2017",
month = "3",
doi = "10.3349/ymj.2017.58.2.370",
language = "English",
volume = "58",
pages = "370--379",
journal = "Yonsei Medical Journal",
issn = "0513-5796",
publisher = "Yonsei University College of Medicine",
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}

Kim, SB, Lee, KH, Lee, JU, Ann, HW, Ahn, JY, Jeon, YD, Kim, JH, Ku, NS, Han, SH, Choi, JY, Song, YG & Kim, JM 2017, 'Long pentraxin 3 as a predictive marker of mortality in severe septic patients who received successful early goal-directed therapy', Yonsei medical journal, vol. 58, no. 2, pp. 370-379. https://doi.org/10.3349/ymj.2017.58.2.370

Long pentraxin 3 as a predictive marker of mortality in severe septic patients who received successful early goal-directed therapy. / Kim, Sun Bean; Lee, Kyoung Hwa; Lee, Ji Un; Ann, Hea Won; Ahn, Jin Young; Jeon, Yong Duk; Kim, Jung Ho; Ku, Nam Su; Han, Sang Hoon; Choi, Jun Yong; Song, Young Goo; Kim, June Myung.

In: Yonsei medical journal, Vol. 58, No. 2, 03.2017, p. 370-379.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long pentraxin 3 as a predictive marker of mortality in severe septic patients who received successful early goal-directed therapy

AU - Kim, Sun Bean

AU - Lee, Kyoung Hwa

AU - Lee, Ji Un

AU - Ann, Hea Won

AU - Ahn, Jin Young

AU - Jeon, Yong Duk

AU - Kim, Jung Ho

AU - Ku, Nam Su

AU - Han, Sang Hoon

AU - Choi, Jun Yong

AU - Song, Young Goo

AU - Kim, June Myung

PY - 2017/3

Y1 - 2017/3

N2 - Purpose: Pentraxin 3 (PTX3) has been suggested to be a prognostic marker of mortality in severe sepsis. Currently, there are limited data on biomarkers including PTX3 that can be used to predict mortality in severe sepsis patients who have undergone successful initial resuscitation through early goal-directed therapy (EGDT). Materials and Methods: A prospective cohort study was conducted among 83 severe sepsis patients with fulfillment of all EGDT components and the achievement of final goal. Plasma PTX3 levels were measured by sandwich ELISA on hospital day (HD) 0, 3, and 7. The data for procalcitonin, C-reactive protein and delta neutrophil index were collected by electric medical record. The primary outcome was 28-day all-cause mortality. Results: 28-day all-cause mortality was 19.3% and the median (interquartile range) APHCH II score of total patients was 16 (13– 19). The non-survivors (n=16) had significantly higher PTX3 level at HD 0 [201.4 (56.9–268.6) ng/mL vs. 36.5 (13.7–145.3) ng/mL, p=0.008]. PTX3 had largest AUCROC value for the prediction of mortality among PTX3, procalcitonin, delta neutrophil index, CRP and APACHE II/SOFA sore at HD 0 [0.819, 95% confidence interval (CI) 0.677–0.961, p=0.008]. The most valid cut-off level of PTX3 at HD 0 was 140.28 ng/mL (sensitivity 66.7%, specificity 73.8%). The PTX3 and procalcitonin at HD 0 showed strong correlation (r=0.675, p<0.001). However, PTX3 at HD 0 was the only independent predictive marker in Cox’s proportional hazards model (≥140 ng/mL; hazard rate 7.16, 95% CI 2.46–15.85, p=0.001). Conclusion: PTX3 at HD 0 could be a powerful predictive biomarker of 28-day all-cause mortality in severe septic patients who have undergone successful EGDT.

AB - Purpose: Pentraxin 3 (PTX3) has been suggested to be a prognostic marker of mortality in severe sepsis. Currently, there are limited data on biomarkers including PTX3 that can be used to predict mortality in severe sepsis patients who have undergone successful initial resuscitation through early goal-directed therapy (EGDT). Materials and Methods: A prospective cohort study was conducted among 83 severe sepsis patients with fulfillment of all EGDT components and the achievement of final goal. Plasma PTX3 levels were measured by sandwich ELISA on hospital day (HD) 0, 3, and 7. The data for procalcitonin, C-reactive protein and delta neutrophil index were collected by electric medical record. The primary outcome was 28-day all-cause mortality. Results: 28-day all-cause mortality was 19.3% and the median (interquartile range) APHCH II score of total patients was 16 (13– 19). The non-survivors (n=16) had significantly higher PTX3 level at HD 0 [201.4 (56.9–268.6) ng/mL vs. 36.5 (13.7–145.3) ng/mL, p=0.008]. PTX3 had largest AUCROC value for the prediction of mortality among PTX3, procalcitonin, delta neutrophil index, CRP and APACHE II/SOFA sore at HD 0 [0.819, 95% confidence interval (CI) 0.677–0.961, p=0.008]. The most valid cut-off level of PTX3 at HD 0 was 140.28 ng/mL (sensitivity 66.7%, specificity 73.8%). The PTX3 and procalcitonin at HD 0 showed strong correlation (r=0.675, p<0.001). However, PTX3 at HD 0 was the only independent predictive marker in Cox’s proportional hazards model (≥140 ng/mL; hazard rate 7.16, 95% CI 2.46–15.85, p=0.001). Conclusion: PTX3 at HD 0 could be a powerful predictive biomarker of 28-day all-cause mortality in severe septic patients who have undergone successful EGDT.

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