Combination of Biomarkers in Predicting 28-Day Mortality for Septic Patients

Objective: To estimate the value of combinative index (combination of routine biomarkers) for predicting 28-day mortality in patients with sepsis. Study Design: An observational study. Place and Duration of Study: Department of Intensive Care Unit, the Second Hospital of Shandong University, Jinan, China, from August 2016 to December 2016. Methodology: Logistic regressions of biomarkers and a combination of biomarkers were performed to investigate risk factors for mortality in patients with sepsis. Several biomarkers were analysed in combination using receiver operating characteristic curves to evaluate the diagnostic performance of combinative index. Results: A total of 59 patients were enrolled; 13 were diagnosed as septic shock. The 28-day mortality rate was 22.0%. Univariate analysis revealed that nonsurvival patients were much older (p=0.022), with higher level of lactate (p=0.012), and with higher level of NT-proBNP (p=0.008) than survival patients. Multivariate logistic regression analysis identified arterial lactate (OR 8.62, 95% CI 1.07-71.43, p=0.043), NT-proBNP (OR 1.00, 95% CI 1.00-1.01, p=0.021), and CRP (OR 1.05, 95% CI 1.01-1.10, p=0.036) as independent predictors for 28-day mortality of septic patients. The combinative index (arterial lactate, NT-proBNP and CRP) displayed a better diagnostic performance than any single indicator (p=0.05, 0.02 and 0.02, respectively). Conclusion: Combinative index (arterial lactate, NT-proBNP and CRP) could serve as a valuable predictor for the 28-day mortality rate in patients with sepsis.