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  • Title: [Prognostic value of lipopolysaccharide binding protein and procalcitonin in patients with severe sepsis and septic shock admitted to intensive care].
    Author: García de Guadiana-Romualdo LM, Rebollo-Acebes S, Esteban-Torrella P, Jiménez-Sánchez R, Hernando-Holgado A, Ortín-Freire A, Viqueira-González M, Trujillo-Santos J, Jiménez Santos E, Pedregosa Díaz J, Albaladejo-Otón MD, Allegue-Gallego JM.
    Journal: Med Intensiva; 2015 May; 39(4):207-12. PubMed ID: 24953001.
    Abstract:
    AIMS: 1) To assess the prognostic value of levels on admission and serial measurements of lipopolysaccharide binding protein (LBP) and procalcitonin (PCT) in relation to in-hospital mortality; and 2) to determine whether the addition of these parameters to severity scores (APACHE II and SOFA) is able to improve prognostic accuracy. DESIGN: A single-center, prospective observational study was carried out. SETTING: Intensive Care unit of a university hospital. PATIENTS: One hundred severe sepsis and septic shock patients were included. DATA COLLECTED: Demographic data, APACHE II and SOFA scores, PCT and LBP levels on admission and after 48 hours, and in-hospital mortality. RESULTS: The best area under the curve for predicting in-hospital mortality corresponded to APACHE II on admission and SOFA after 48 h (AUC ROC: 0.75 for both). PCT and LBP levels on admission and LBP clearance were not statistically different between in-hospital survivors and non-survivors. Only PCT clearance was higher among in-hospital survivors than in non-survivors (AUC ROC: 0.66). The combination of severity scores and PCT clearance did not result in superior areas under the curve. CONCLUSIONS: LBP and PCT levels on admission and LBP clearance showed no prognostic value in severe sepsis and septic shock patients. Only PCT clearance was predictive of in-hospital mortality. The prognostic accuracy was significantly better for APACHE on admission and SOFA after 48 h than for any of the analyzed biomarkers, and the addition of PCT clearance did not improve their prognostic value.
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