Soluble fms-like tyrosine kinase 1, placental growth factor and procalcitonin as biomarkers of gram-negative sepsis: Analysis through a derivation and a validation cohort. Issue 44 (5th November 2021)

• Record Type: Journal Article
• Authors: Vittoros, Vasileios; Kyriazopoulou, Evdoxia; Lada, Malvina; Tsangaris, Iraklis; Koutelidakis, Ioannis M.; Giamarellos-Bourboulis, Evangelos J.
• Other Names: Jain. Nikhil section editor.
• Is Part Of: Medicine. Volume 100:Issue 44(2021)
• Publication Date: 2021-11-05
• Subjects: diagnosis -- procalcitonin -- prognosis -- sepsis -- s-Flt-1; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000027662
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: Further improvement of the diagnostic and prognostic performance of biomarkers for the critically ill is needed. Procalcitonin (PCT), placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 raise interest for sepsis diagnosis and prognosis. Serum samples from 2 cohorts of 172 patients (derivation cohort) and of 164 patients (validation cohort) comprising only patients with microbiologically confirmed gram-negative infections were analyzed. PlGF, s-Flt-1 and procalcitonin (PCT) were measured in serum within 24 hours from sepsis onset and repeated on days 3 and 7. PCT and s-Flt-1 baseline levels were higher in sepsis and septic shock compared to non-sepsis; this was not the case for PlGF. s-Flt-1 at concentrations greater than 60 pg/ml diagnosed sepsis with sensitivity 72.3% and specificity 54.9% whereas at concentrations greater than 70 pg/ml predicted unfavorable outcome with specificity 73.0% and sensitivity 63.7%. At least 80% decrease of PCT and/or PCT less than 0.5 ng/ml on day 7 was protective from sepsis-associated death. Both s-Flt-1 and PCT should be measured in the critically ill since they provide additive information for sepsis diagnosis and prognosis. ClinicalTrials.gov numbers NCT01223690 and NCT00297674.