The predictive value of the inflammatory markers P-selectin and MCP1 in determining the length of stay and 30-day survival in the differentiation of sepsis patients
Duman, A.; Turkdogan, K.A.; Avcil, M.; Yenisey, C.; Ture, M.; Akoz, A.; Dagli, B.; Kapci, M.; Orun, S.
JPMA. Journal of the Pakistan Medical Association 68(9): 1321-1326
2018
ISSN/ISBN: 0030-9982 PMID: 30317258 Document Number: 696191
Sepsis is the leading disease that is diagnosed late and still has a mortal course in emergency departments. The primary factors that will reduce both morbidity and mortality are early diagnosis and an early treatment approach. Therefore, in this study, P-selectin and MCP1 levels, which are known to be markers of inflammation, were examined in patients being followed up in intensive care. Patients evaluated with a preliminary diagnosis of sepsis in the emergency intensive care unit between September 2015 and August 2016 were classified as having sepsis or infection according to the Q- SOFA criteria, and the P- selectin values were compared. In the sepsis group, GCS was determined as 13 (12-13), SBP 90 (80-110), tachypnea 24 (22-26), lactate 3.8 (0.6-16.0), MAP 70 (60-77), and LOS 16 days (9.5-20.3). In the ROC analysis, the sensitivity of P-selectin and MCP1 in the differentiation of patients with and without sepsis was 95.7%, and 73.8%, and the specificity was 97.8% and 73.8%, respectively. According to the cutoff values, the sensitivity and specificity in the prediction of patient mortality were 71.4% and 65.6% in P- selectin and 78.6% and 65.6% in MCP1. The P-selectin and MCP1 values in the emergency department can differentiate sepsis patients according to the Q-SOFA criteria and showed 30-day mortality at a significant level. Therefore, in patients with suspected sepsis in an emergency department, MCP1 can be of benefit to physicians in their decisions regarding LOS and transfer to intensive care.