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.

Autor:	Duman A; Department of Faculty of Medicine, Adnan Menderes Universtiy, Aydin., Turkdogan KA; Department of Faculty of Medicine, Adnan Menderes Universtiy, Aydin., Avcil M; Department of Faculty of Medicine, Adnan Menderes Universtiy, Aydin., Yenisey C; Department of Biochemistry, Adnan Menderes Universtiy, Aydin., Ture M; Department of Biochemistry, Adnan Menderes Universtiy, Aydin., Akoz A; Department of Faculty of Medicine, Adnan Menderes Universtiy, Aydin., Dagli B; Department of Emergency Medicine, Adnan Menderes Universtiy, Aydin., Kapci M; Department of Emergency Medicine, Adnan Menderes Universtiy, Aydin., Orun S; Emergecy Service, Bandirma State Hospital, Balikesir, Turkey.
Jazyk:	angličtina
Zdroj:	JPMA. The Journal of the Pakistan Medical Association [J Pak Med Assoc] 2018 Sep; Vol. 68 (9), pp. 1321-1326.
Abstrakt:	Objective: 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. Methods: 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. Results: 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. Conclusions: 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.
Databáze:	MEDLINE
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