Changes in Heparin-Binding Protein, Procalcitonin, and C-Reactive Protein Within the First 72 Hours Predict 28-Day Mortality in Patients Admitted to the Intensive Care Unit with Septic Shock

BACKGROUND: This study aimed to evaluate the possible associations of heparin-binding protein (HBP), procalcitonin (PCT), and C-reactive protein (CRP) levels with 28-day mortality in septic shock patients admitted to Intensive Care Units (ICUs). MATERIAL AND METHODS: Blood samples were taken at ICU admission and measured again 72 h later to calculate changes in HBP (Delta HBP), changes in PCT (Delta PCT), changes in CRP (Delta CRP), and changes in Sequential Organ Failure Assessment (DSOFA) relative to baseline. RESULTS: Variables included in the univariable logistic regression model for survival were age, Acute Physiology and Chronic Health Evaluation (APACHE) II scores, decreasing Delta SOFA, decreasing DHBP, decreasing Delta PCT, and decreasing Delta CRP. Survival was directly related to decreasing Delta HBP with odds ratio (OR)=9.95 (95% confidence interval [CI] 4.63 to 21.35; P<0.001), decreasing Delta PCT with OR=7.85 (3.74 to 16.49; P<0.001), decreasing Delta CRP with OR=5.83 (2.84 to 11.97; P<0.001), decreasing Delta SOFA with OR=1.93 (1.00 to 3.75; P=0.051) and APACHE II score with OR=1.93 (1.14 to 1.68; P=0.001). In a multivariable logistic regression model for survival, only decreasing DHBP with OR=7.18 (2.91 to 17.69; P<0.001), decreasing Delta PCT with OR=5.17 (2.12 to 12.56; P<0.001), and decreasing Delta CRP with OR=4.33 (1.77 to 10.61; P=0.001) remained significant. CONCLUSIONS: Measuring changes in HBP, PCT, and CRP within 72 h of admission may aid in predicting 28-day mortality for patients with septic shock in ICUs.