Diagnostic and Predictive Values of Soluble Triggering Receptor Expressed on Myeloid Cells-1 in Sepsis: A Multi-Center Prospective Clinical Study

Abstract

Kaifei Wang,1,* Youchen Zhang,2,* Lei Sang,3,* Ye Hu,1,* Longxiang Su,4 Sheling Xie,1 Kun Xiao,1 Jianqiao Xu,1 Jiang Wang,1 Fei Xie,1 Guangfa Zhu,5 Shihui Fu,6– 8 Lixin Xie1 1College of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Department of Pediatrics, Hainan Hospital of Chinese PLA General Hospital, Sanya, People’s Republic of China; 3Information Department, Hainan Hospital of Chinese PLA General Hospital, Sanya, People’s Republic of China; 4Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 5Department of Pulmonary and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, People’s Republic of China; 6Department of Cardiology, Hainan Hospital of Chinese PLA General Hospital, Hainan Geriatric Disease Clinical Medical Research Center, Hainan Branch of China Geriatric Disease Clinical Research Center, Sanya, People’s Republic of China; 7Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People’s Republic of China; 8The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shihui Fu, Department of Cardiology, Hainan Hospital of Chinese PLA General Hospital, Hainan Geriatric Disease Clinical Medical Research Center, Hainan Branch of China Geriatric Disease Clinical Research Center, Sanya, People’s Republic of China, Email [email protected] Lixin Xie, College of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, People’s Republic of China, Email [email protected]: To determine diagnostic values of serum and urine soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in sepsis including septic shock and their predictive values for clinical prognosis and sepsis-associated acute kidney injury (AKI).Methods: A multi-center prospective research method was used to enroll patients with sepsis.Results: A total of 586 cases were studied, including 238 patients with sepsis and 348 healthy individuals. In the sepsis group, 84 patients (35.3%) were diagnosed with septic shock, and 93 patients (38.1%) were diagnosed with AKI. The area under the Receiver Operating Characteristic curve (AUC) for diagnosing sepsis was 0.892 (0.862– 0.922). When the cut-off value was 295 pg/mL, the sensitivity was 76.8%, and the specificity was 89.1%. The AUC for predicting AKI was 0.803 (0.739– 0.866). When the cut-off value was 485 pg/mL, the sensitivity was 88.4%, and the specificity was 65.8%.Conclusion: sTREM-1 is a good indicator for the diagnosis of sepsis and septic shock and significantly correlated with clinical prognosis and sepsis-associated AKI in patients with sepsis. Diagnostic and predictive values of sTREM-1 may be related to inflammatory storm mediated by TREM-1. Further mechanistic explanation or preliminary evidence in combination with clinical study with more patients will benefit for supporting diagnostic and predictive utilities of sTREM-1 in sepsis.Keywords: acute kidney injury, clinical prognosis, sepsis, septic shock, soluble triggering receptor expressed on myeloid cells-1

Keywords

• acute kidney injury
• clinical prognosis
• sepsis
• septic shock
• soluble triggering receptor expressed on myeloid cells-1