Serum adhesion molecules as outcome predictors in adult severe sepsis patients requiring mechanical ventilation in the emergency department

Chia Te Kung; Chih Min Su; Hsueh Wen Chang; Hsien Hung Cheng; Sheng Yuan Hsiao; Tsung Cheng Tsai; Wen Neng Chang; Nai Wen Tsai; Hung Chen Wang; Yu Jih Su; Chin Cheng Huang; Wei Che Lin; Ben Chung Cheng; Ya Ting Chang; Yi Fang Chiang; Cheng Hsien Lu

doi:10.1016/j.clinbiochem.2014.06.020

Serum adhesion molecules as outcome predictors in adult severe sepsis patients requiring mechanical ventilation in the emergency department

Chia Te Kung, Chih Min Su, Hsueh Wen Chang, Hsien Hung Cheng, Sheng Yuan Hsiao, Tsung Cheng Tsai, Wen Neng Chang, Nai Wen Tsai, Hung Chen Wang, Yu Jih Su, Chin Cheng Huang, Wei Che Lin, Ben Chung Cheng, Ya Ting Chang, Yi Fang Chiang, Cheng Hsien Lu^*

^*Corresponding author for this work

School of Medicine

Research output: Contribution to journal › Journal Article › peer-review

9 Scopus citations

Abstract

Background and aim: Serum adhesion molecules play a pivotal role in the pathogenesis of sepsis syndrome. This study aimed to evaluate the prognostic value of serum adhesion molecules in patients with severe sepsis and mechanical ventilation (MV) at the emergency department. Methods: Eighty-seven consecutive patients with severe sepsis, including 35 with MV, were evaluated. Serum samples were collected for analysis of serum adhesion molecules. The patients' clinical and laboratory data on admission were also recorded. Results: The maximum 24-h APACHE II and 24-h SOFA scores were significantly higher in the severe sepsis patients requiring MV than in patients without MV (. p=. 0.02 and p<. 0.001). Mortality rate was significantly higher in severe sepsis patients requiring MV than in patients without MV (40% [14/35] vs. 9.6% [5/52], p=. 0.001).Both VCAM-1 level (. p=. 0.03) and lactate concentration (. p=. 0.04) on admission had significant differences between survivors and non-survivors in patients requiring MV. In the logistic regression model, only VCAM-1 level (. p=. 0.049) was independently predictive of mortality. By correlation analysis, lactate concentration significantly correlated with the mean VCAM-1 level on admission (. γ=. 0.484, p=. 0.004). The area under the ROC curve for VCAM-1 level was 0.747 (. p=. 0.02, 95% CI: 0.576-0.918). The cut-off value of VCAM-1 level for predicting hospital mortality in severe sepsis patients receiving MV was 1870. ng/mL, with 77% sensitivity and 71% specificity; then the likelihood ratio equals 2.7. Conclusions: In this study, VCAM-1 level is a more powerful outcome predictor of hospital mortality in severe sepsis patients requiring MV than lactate concentration and other conventional parameters on admission. This suggests that increased plasma VCAM-1 concentration may be useful in identifying who are at risk of hospital mortality among severely septic patients requiring MV.

Original language	English
Pages (from-to)	38-43
Number of pages	6
Journal	Clinical Biochemistry
Volume	47
Issue number	15
DOIs	https://doi.org/10.1016/j.clinbiochem.2014.06.020
State	Published - 01 12 2014

Bibliographical note

Publisher Copyright:
© 2014 The Canadian Society of Clinical Chemists.

Keywords

Outcome
Serum adhesion molecules
Severe sepsis

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10.1016/j.clinbiochem.2014.06.020

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Kung, C. T., Su, C. M., Chang, H. W., Cheng, H. H., Hsiao, S. Y., Tsai, T. C., Chang, W. N., Tsai, N. W., Wang, H. C., Su, Y. J., Huang, C. C., Lin, W. C., Cheng, B. C., Chang, Y. T., Chiang, Y. F., & Lu, C. H. (2014). Serum adhesion molecules as outcome predictors in adult severe sepsis patients requiring mechanical ventilation in the emergency department. Clinical Biochemistry, 47(15), 38-43. https://doi.org/10.1016/j.clinbiochem.2014.06.020

@article{1d3628cac95c48179e8fc8ce3ac8cf10,

title = "Serum adhesion molecules as outcome predictors in adult severe sepsis patients requiring mechanical ventilation in the emergency department",

abstract = "Background and aim: Serum adhesion molecules play a pivotal role in the pathogenesis of sepsis syndrome. This study aimed to evaluate the prognostic value of serum adhesion molecules in patients with severe sepsis and mechanical ventilation (MV) at the emergency department. Methods: Eighty-seven consecutive patients with severe sepsis, including 35 with MV, were evaluated. Serum samples were collected for analysis of serum adhesion molecules. The patients' clinical and laboratory data on admission were also recorded. Results: The maximum 24-h APACHE II and 24-h SOFA scores were significantly higher in the severe sepsis patients requiring MV than in patients without MV (. p=. 0.02 and p<. 0.001). Mortality rate was significantly higher in severe sepsis patients requiring MV than in patients without MV (40% [14/35] vs. 9.6% [5/52], p=. 0.001).Both VCAM-1 level (. p=. 0.03) and lactate concentration (. p=. 0.04) on admission had significant differences between survivors and non-survivors in patients requiring MV. In the logistic regression model, only VCAM-1 level (. p=. 0.049) was independently predictive of mortality. By correlation analysis, lactate concentration significantly correlated with the mean VCAM-1 level on admission (. γ=. 0.484, p=. 0.004). The area under the ROC curve for VCAM-1 level was 0.747 (. p=. 0.02, 95% CI: 0.576-0.918). The cut-off value of VCAM-1 level for predicting hospital mortality in severe sepsis patients receiving MV was 1870. ng/mL, with 77% sensitivity and 71% specificity; then the likelihood ratio equals 2.7. Conclusions: In this study, VCAM-1 level is a more powerful outcome predictor of hospital mortality in severe sepsis patients requiring MV than lactate concentration and other conventional parameters on admission. This suggests that increased plasma VCAM-1 concentration may be useful in identifying who are at risk of hospital mortality among severely septic patients requiring MV.",

keywords = "Outcome, Serum adhesion molecules, Severe sepsis",

author = "Kung, {Chia Te} and Su, {Chih Min} and Chang, {Hsueh Wen} and Cheng, {Hsien Hung} and Hsiao, {Sheng Yuan} and Tsai, {Tsung Cheng} and Chang, {Wen Neng} and Tsai, {Nai Wen} and Wang, {Hung Chen} and Su, {Yu Jih} and Huang, {Chin Cheng} and Lin, {Wei Che} and Cheng, {Ben Chung} and Chang, {Ya Ting} and Chiang, {Yi Fang} and Lu, {Cheng Hsien}",

note = "Publisher Copyright: {\textcopyright} 2014 The Canadian Society of Clinical Chemists.",

year = "2014",

month = dec,

day = "1",

doi = "10.1016/j.clinbiochem.2014.06.020",

language = "英语",

volume = "47",

pages = "38--43",

journal = "Clinical Biochemistry",

issn = "0009-9120",

publisher = "Elsevier Inc.",

number = "15",

}

Kung, CT, Su, CM, Chang, HW, Cheng, HH, Hsiao, SY, Tsai, TC, Chang, WN, Tsai, NW, Wang, HC, Su, YJ, Huang, CC, Lin, WC, Cheng, BC, Chang, YT, Chiang, YF & Lu, CH 2014, 'Serum adhesion molecules as outcome predictors in adult severe sepsis patients requiring mechanical ventilation in the emergency department', Clinical Biochemistry, vol. 47, no. 15, pp. 38-43. https://doi.org/10.1016/j.clinbiochem.2014.06.020

TY - JOUR

T1 - Serum adhesion molecules as outcome predictors in adult severe sepsis patients requiring mechanical ventilation in the emergency department

AU - Kung, Chia Te

AU - Su, Chih Min

AU - Chang, Hsueh Wen

AU - Cheng, Hsien Hung

AU - Hsiao, Sheng Yuan

AU - Tsai, Tsung Cheng

AU - Chang, Wen Neng

AU - Tsai, Nai Wen

AU - Wang, Hung Chen

AU - Su, Yu Jih

AU - Huang, Chin Cheng

AU - Lin, Wei Che

AU - Cheng, Ben Chung

AU - Chang, Ya Ting

AU - Chiang, Yi Fang

AU - Lu, Cheng Hsien

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Background and aim: Serum adhesion molecules play a pivotal role in the pathogenesis of sepsis syndrome. This study aimed to evaluate the prognostic value of serum adhesion molecules in patients with severe sepsis and mechanical ventilation (MV) at the emergency department. Methods: Eighty-seven consecutive patients with severe sepsis, including 35 with MV, were evaluated. Serum samples were collected for analysis of serum adhesion molecules. The patients' clinical and laboratory data on admission were also recorded. Results: The maximum 24-h APACHE II and 24-h SOFA scores were significantly higher in the severe sepsis patients requiring MV than in patients without MV (. p=. 0.02 and p<. 0.001). Mortality rate was significantly higher in severe sepsis patients requiring MV than in patients without MV (40% [14/35] vs. 9.6% [5/52], p=. 0.001).Both VCAM-1 level (. p=. 0.03) and lactate concentration (. p=. 0.04) on admission had significant differences between survivors and non-survivors in patients requiring MV. In the logistic regression model, only VCAM-1 level (. p=. 0.049) was independently predictive of mortality. By correlation analysis, lactate concentration significantly correlated with the mean VCAM-1 level on admission (. γ=. 0.484, p=. 0.004). The area under the ROC curve for VCAM-1 level was 0.747 (. p=. 0.02, 95% CI: 0.576-0.918). The cut-off value of VCAM-1 level for predicting hospital mortality in severe sepsis patients receiving MV was 1870. ng/mL, with 77% sensitivity and 71% specificity; then the likelihood ratio equals 2.7. Conclusions: In this study, VCAM-1 level is a more powerful outcome predictor of hospital mortality in severe sepsis patients requiring MV than lactate concentration and other conventional parameters on admission. This suggests that increased plasma VCAM-1 concentration may be useful in identifying who are at risk of hospital mortality among severely septic patients requiring MV.

AB - Background and aim: Serum adhesion molecules play a pivotal role in the pathogenesis of sepsis syndrome. This study aimed to evaluate the prognostic value of serum adhesion molecules in patients with severe sepsis and mechanical ventilation (MV) at the emergency department. Methods: Eighty-seven consecutive patients with severe sepsis, including 35 with MV, were evaluated. Serum samples were collected for analysis of serum adhesion molecules. The patients' clinical and laboratory data on admission were also recorded. Results: The maximum 24-h APACHE II and 24-h SOFA scores were significantly higher in the severe sepsis patients requiring MV than in patients without MV (. p=. 0.02 and p<. 0.001). Mortality rate was significantly higher in severe sepsis patients requiring MV than in patients without MV (40% [14/35] vs. 9.6% [5/52], p=. 0.001).Both VCAM-1 level (. p=. 0.03) and lactate concentration (. p=. 0.04) on admission had significant differences between survivors and non-survivors in patients requiring MV. In the logistic regression model, only VCAM-1 level (. p=. 0.049) was independently predictive of mortality. By correlation analysis, lactate concentration significantly correlated with the mean VCAM-1 level on admission (. γ=. 0.484, p=. 0.004). The area under the ROC curve for VCAM-1 level was 0.747 (. p=. 0.02, 95% CI: 0.576-0.918). The cut-off value of VCAM-1 level for predicting hospital mortality in severe sepsis patients receiving MV was 1870. ng/mL, with 77% sensitivity and 71% specificity; then the likelihood ratio equals 2.7. Conclusions: In this study, VCAM-1 level is a more powerful outcome predictor of hospital mortality in severe sepsis patients requiring MV than lactate concentration and other conventional parameters on admission. This suggests that increased plasma VCAM-1 concentration may be useful in identifying who are at risk of hospital mortality among severely septic patients requiring MV.

KW - Outcome

KW - Serum adhesion molecules

KW - Severe sepsis

UR - http://www.scopus.com/inward/record.url?scp=84910035320&partnerID=8YFLogxK

U2 - 10.1016/j.clinbiochem.2014.06.020

DO - 10.1016/j.clinbiochem.2014.06.020

M3 - 文章

C2 - 24998754

AN - SCOPUS:84910035320

SN - 0009-9120

VL - 47

SP - 38

EP - 43

JO - Clinical Biochemistry

JF - Clinical Biochemistry

IS - 15

ER -

Serum adhesion molecules as outcome predictors in adult severe sepsis patients requiring mechanical ventilation in the emergency department

Abstract

Bibliographical note

Keywords

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