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2 "biomarkers"
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Original Articles
Surgery
Biomarkers to predict mortality in patients with Fournier’s gangrene admitted to the intensive care unit after surgery in South Korea
In Sik Shin, Seong Chan Gong, Sanghyun An, Kwangmin Kim
Acute Crit Care. 2023;38(4):452-459.   Published online November 21, 2023
DOI: https://doi.org/10.4266/acc.2023.00766
  • 1,363 View
  • 40 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
The use of biomarkers to predict patient outcomes may be crucial for patients admitted to the intensive care unit (ICU) following surgery because biomarkers guide clinicians in tailoring treatment plans accordingly. Therefore, we aimed to identify potential biomarkers to predict the prognosis of patients with Fournier’s gangrene (FG) admitted to the ICU after surgery.
Methods
We enrolled patients with FG admitted to our Hospital between January 2013 and December 2022. We retrospectively analyzed patient characteristics, factors related to management, scores known to be associated with the prognosis of FG, and laboratory data.
Results
The study population included 28 survivors and 13 nonsurvivors. The initial serum lactate level taken in the emergency department; white blood cell, neutrophil, and platelet counts; delta neutrophil index and international normalized ratio; albumin, glucose, HCO3, and postoperative lactate levels; and the laboratory risk indicator for necrotizing fasciitis differed between survivors and nonsurvivors. Postoperative lactate and initial albumin levels were independent predictors of mortality in patients with FG. In the receiver operating characteristic curve analysis, the postoperative lactate level was the best indicator of mortality (area under the curve, 0.877; 95% confidence interval, 0.711–1.000). The optimal cutoff postoperative lactate level for predicting mortality was 3.0 mmol/L (sensitivity, 80.0%; specificity, 95.0%).
Conclusions
Postoperative lactate and initial albumin levels could be potential predictors of mortality in patients with FG admitted to the ICU after surgery, and the optimal cutoff postoperative lactate and initial albumin levels to predict mortality were 3.0 mmol/L and 3.05 g/dl, respectively. Large-scale multicenter prospective studies are required to confirm our results.

Citations

Citations to this article as recorded by  
  • Risk Factors for Mortality Among Patients With Fournier Gangrene: A Systematic Review
    Pavan Shet, Ashmit Daiyan Mustafa, Karan Varshney, Lavina Rao, Sameen Sawdagar, Florence McLennan, Siraaj Ansari, Darshan Shet, Niveshan Sivathamboo, Sian Campbell
    Surgical Infections.2024; 25(4): 261.     CrossRef
Infection
Validation of presepsin measurement for mortality prediction of sepsis: a preliminary study
Seung Min Baik, Jin Park, Tae Yoon Kim, Se Hong Choi, Kyung Sook Hong
Acute Crit Care. 2022;37(4):527-532.   Published online August 19, 2022
DOI: https://doi.org/10.4266/acc.2022.00150
  • 2,842 View
  • 148 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
Sepsis and septic shock remain the leading causes of death in critically ill patients worldwide. Various biomarkers are available to determine the prognosis and therapeutic effects of sepsis. In this study, we investigated the effectiveness of presepsin as a sepsis biomarker. Methods: Patients admitted to the intensive care unit with major or minor diagnosis of sepsis were categorized into survival and non-survival groups. The white blood cell count and serum C-reactive protein, procalcitonin, and presepsin levels were measured in all patients. Results: The study included 40 patients (survival group, 32; non-survival group, 8; mortality rate, 20%). The maximum serum presepsin levels measured during intensive care unit admission were significantly higher in the non-survival group (median [interquartile range]: 4,205.5 pg/ml [1,155.8–10,094.0] vs. 741.5 pg/ml [520.0–1,317.5], P<0.05). No statistically significant intergroup differences were observed in the maximum, minimum, and mean values of the white blood cell count, as well as serum C-reactive protein, and procalcitonin levels. Based on the receiver operating characteristic curve, the area under the curve for presepsin as a predictor of sepsis mortality was 0.764. At a cut-off value of 1,898.5 pg/ml, the sensitivity and specificity of presepsin for prediction of sepsis-induced mortality were 75.0% and 87.5%, respectively. Conclusions: Early diagnosis of sepsis and prediction of sepsis-induced mortality are important for prompt initiation of treatment. Presepsin may serve as an effective biomarker for prediction of sepsis-induced mortality and for evaluation of treatment effectiveness.

Citations

Citations to this article as recorded by  
  • The Potential Role of Presepsin in Predicting Severe Infection in Patients with Diabetic Foot Ulcers
    Eun Yeong Ha, Il Rae Park, Seung Min Chung, Young Nam Roh, Chul Hyun Park, Tae-Gon Kim, Woong Kim, Jun Sung Moon
    Journal of Clinical Medicine.2024; 13(8): 2311.     CrossRef
  • Combined estimation of presepsin and gelsolin might improve the diagnostic validity of clinical scoring to predict and stratify sepsis in non-sepsis surgical ICU patient
    Hany A. Shehab, Ahmed M Eid, Yehya Shahin Dabour
    Egyptian Journal of Anaesthesia.2024; 40(1): 262.     CrossRef

ACC : Acute and Critical Care