Abstract：
OBJECTIVE: 1) To evaluate the ability of baseline and on 24 h serum calprotectin, in comparison to canonical biomarkers (lactate and procalcitonin), for prognosis of 28-day mortality in critically ill septic patients; and 2) To develop a predictive model combining the three biomarkers.
METHODS: A single-center, retrospective study.
METHODS: Intensive Care Unit of a university hospital.
METHODS: One hundred and seventy three septic pacientes were included.
METHODS: Measurement of baseline lactate, procalcitonin and calprotectin level and procalcitonin and calprotectin levels on 24 h.
METHODS: Demographics and comorbidities, SOFA score on ICU admission, baseline lactate, procalcitonin and calprotectin on admission and on 24 h and 28-day mortality.
RESULTS: 1) On ICU admission, lactate was the only biomarker achieving a significant accuracy (AUC: 0.698); 2) On 24 h, no differences were found on procalcitonin and calprotectin levels. Procalcitonin and calprotectin clearances were significantly lower in non-survivors and both achieved a moderate performance (AUCs: 0.668 and 0.664, respectively); 3) A biomarker based-model achieved a significant accuracy (AUC: 0.766), trending to increase (AUC: 0.829) to SOFA score alone; y 4) Baseline lactate levels and procalcitonin and calprotectin clearance were independent predictors for the outcome.
CONCLUSIONS: 1) Baseline and on 24 h calprotectina and procalcitonin levels lacked ability in predicting 28-day mortality; 2) Accuracy of clearance of both biomarkers was moderate; and 3) Combination of SOFA score and the predictive biomarker based-model showed a high prognostic accuracy.
METHODS: A single-center, retrospective study.
METHODS: Intensive Care Unit of a university hospital.
METHODS: One hundred and seventy three septic pacientes were included.
METHODS: Measurement of baseline lactate, procalcitonin and calprotectin level and procalcitonin and calprotectin levels on 24 h.
METHODS: Demographics and comorbidities, SOFA score on ICU admission, baseline lactate, procalcitonin and calprotectin on admission and on 24 h and 28-day mortality.
RESULTS: 1) On ICU admission, lactate was the only biomarker achieving a significant accuracy (AUC: 0.698); 2) On 24 h, no differences were found on procalcitonin and calprotectin levels. Procalcitonin and calprotectin clearances were significantly lower in non-survivors and both achieved a moderate performance (AUCs: 0.668 and 0.664, respectively); 3) A biomarker based-model achieved a significant accuracy (AUC: 0.766), trending to increase (AUC: 0.829) to SOFA score alone; y 4) Baseline lactate levels and procalcitonin and calprotectin clearance were independent predictors for the outcome.
CONCLUSIONS: 1) Baseline and on 24 h calprotectina and procalcitonin levels lacked ability in predicting 28-day mortality; 2) Accuracy of clearance of both biomarkers was moderate; and 3) Combination of SOFA score and the predictive biomarker based-model showed a high prognostic accuracy.
摘要：
目的：1）评估基线和24h血清钙卫蛋白的能力，与经典生物标志物（乳酸和降钙素原）相比，用于危重脓毒症患者28天死亡率的预后;和2)建立结合三种生物标志物的预测模型。
方法：单中心，回顾性研究。
方法：大学医院重症监护病房。
方法：纳入了一百七十三个脓毒症患者。
方法：测量基线乳酸，降钙素原和钙卫蛋白水平以及降钙素原和钙卫蛋白水平在24小时。
方法：人口统计学和合并症，入住ICU的SOFA评分，基线乳酸，入院时降钙素原和钙卫蛋白以及24小时和28天死亡率。
结果：1）入住ICU时，乳酸是唯一具有显著准确性的生物标志物(AUC：0.698)；2)在24小时，降钙素原和钙网蛋白水平无差异.降钙素原和钙卫蛋白清除率在非存活者中显著较低，并且均达到中等性能（AUC：分别为0.668和0.664）；3）基于生物标志物的模型达到了显着的准确性（AUC：0.766），仅SOFA评分有增加趋势(AUC:0.829);y4)基线乳酸水平、降钙素原和钙卫蛋白清除率是结局的独立预测因子.
结论：1）基线和24小时钙网和降钙素原水平缺乏预测28天死亡率的能力；2）两种生物标志物清除的准确性中等；3）SOFA评分和基于预测生物标志物的模型的组合显示出较高的预后准确性。
方法：单中心，回顾性研究。
方法：大学医院重症监护病房。
方法：纳入了一百七十三个脓毒症患者。
方法：测量基线乳酸，降钙素原和钙卫蛋白水平以及降钙素原和钙卫蛋白水平在24小时。
方法：人口统计学和合并症，入住ICU的SOFA评分，基线乳酸，入院时降钙素原和钙卫蛋白以及24小时和28天死亡率。
结果：1）入住ICU时，乳酸是唯一具有显著准确性的生物标志物(AUC：0.698)；2)在24小时，降钙素原和钙网蛋白水平无差异.降钙素原和钙卫蛋白清除率在非存活者中显著较低，并且均达到中等性能（AUC：分别为0.668和0.664）；3）基于生物标志物的模型达到了显着的准确性（AUC：0.766），仅SOFA评分有增加趋势(AUC:0.829);y4)基线乳酸水平、降钙素原和钙卫蛋白清除率是结局的独立预测因子.
结论：1）基线和24小时钙网和降钙素原水平缺乏预测28天死亡率的能力；2）两种生物标志物清除的准确性中等；3）SOFA评分和基于预测生物标志物的模型的组合显示出较高的预后准确性。
