The Value Of SuPar And PCT For Assessment Of Disease Severity And Prognosis In Sepsis

Objective: To evaluate the value of plasma soluble urokinase plasminogen activator receptor(suPAR) and serum Procalcitonin(PCT) to investigate their assessment of disease severity and prognosis in patients with sepsis.Methods: There were 125 critically ill patients who admitted to the emergency intensive care unit(EICU) as research subjects, and 77 patients were diagnosed as sepsis finally. The levels of plasma suPAR and serum PCT were monitored in 77 patients with sepsis. The acute physiology and chronic health evaluation II(APACHEII) and sequential organ failure assessment(SOFA) score were recorded. According to the disease severity and their prognosis, the value of plasma suPAR,serum PCT,APACHE II and SOFA score which predict the disease severity and prognosis of septic patients were compared. Correlation analysis were carried out on plasma suPAR,serum PCT,APACHEII and SOFA score.Results: The level of plasma suPAR in septic patients(7.9±6.5ng/ml)was lower than severe sepsis patients(8.4±4.5ng/ml) and septic shock patients(13.9±8.0ng/ml)(P all<0.05) within the first 24 h after admission.The level of serum PCT in septic patients(6.3±3.5ng/ml) was lower than the severe sepsis patients(23.7±3.9ng/ml) and septic shock patients(25.7±4.3ng/ml)(P all<0.05). But there was no significant difference in the level of serum PCT between the severe sepsis group and the septic shock group within the first 24 h after admission. Receiver operator characteristic curve(ROC curve) could distinguish survivors from non-survivors in septic patients, And the maximal area under curve(AUC) of serum PCT was0.61(P>0.05), the AUC of APACHEII score was 0.832(P<0.05), the AUC of SOFA score was 0.767(P<0.05), and the AUC of plasma suPAR was0.803. The best cut-off value of plasma suPAR to distinguish survivors from non-survivors was 9.905 ng/mL, which the sensitivity was 83.3% and the specificity was 73.8%. The AUC was 0.881 when combine suPAR with APACHE II score in distinguishing survivors from non-survivors, which was higher than each single index(suPAR:AUC 0.803, APACHE II score:AUC 0.832). Positive correlations were found between plasma suPAR and serum PCT(r=0.27,P<0.05), plasma suPAR and APACHEII score(r=0.499,P<0.05), plasma suPAR and SOFA score(r=0.487,P<0.05).Conclusions: As a new biomarker, the plasma suPAR is better thanserum PCT in the assessment of the disease severity and prognosis of septic patients. To combine plasma suPAR with APACHE II score may can improve the predict accuracy of disease severity and prognosis in sepsis.Monitoring of the levels of plasma suPAR and the APACHEII score may help to assess the severity and the prognosis of sepsis in the early stage.