Dynamic changes in heparin-binding protein as a prognostic biomarker for 30-day mortality in sepsis patients in the intensive care unit
Journal
Scientific reports
Journal Volume
12
Journal Issue
1
Date Issued
2022-06-24
Author(s)
Dou, Qing-Li
Liu, Jiangping
Zhang, Wenwu
Wang, Ching-Wei
Gu, Yanan
Li, Na
Hu, Rui
Hsu, Wan-Ting
Huang, Amy Huaishiuan
Tong, Hoi Sin
Hsu, Tzu-Chun
Hsu, Cheng-An
Xu, Jun
Abstract
Heparin-binding protein (HBP) has been shown to be a robust predictor of the progression to organ dysfunction from sepsis, and we hypothesized that dynamic changes in HBP may reflect the severity of sepsis. We therefore aim to investigate the predictive value of baseline HBP, 24-h, and 48-h HBP change for prediction of 30-day mortality in adult patients with sepsis. This is a prospective observational study in an intensive care unit of a tertiary center. Patients aged 20 years or older who met SEPSIS-3 criteria were prospectively enrolled from August 2019 to January 2020. Plasma levels of HBP were measured at admission, 24 h, and 48 h and dynamic changes in HBP were calculated. The Primary endpoint was 30-day mortality. We tested whether the biomarkers could enhance the predictive accuracy of a multivariable predictive model. A total of 206 patients were included in the final analysis. 48-h HBP change (HBPc-48 h) had greater predictive accuracy of area under the curve (AUC: 0.82), followed by baseline HBP (0.79), PCT (0.72), lactate (0.71), and CRP (0.65), and HBPc-24 h (0.62). Incorporation of HBPc-48 h into a clinical prediction model significantly improved the AUC from 0.85 to 0.93. HBPc-48 h may assist clinicians with clinical outcome prediction in critically ill patients with sepsis and can improve the performance of a prediction model including age, SOFA score and Charlson comorbidity index.
Subjects
SEPTIC SHOCK PATIENTS; ORGAN DYSFUNCTION; TRENDS; PREDICTION
SDGs
Publisher
NATURE PORTFOLIO
Type
journal article