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Prognostic value of plasma 7-ketocholesterol in sepsis.
Zhang, Yueyuan; Xu, Sha; Xu, Jianxin; Xu, Fuchao; Lu, Geng; Zhou, Jiawei; Gu, Shuangshuang; Wang, Jun.
Afiliación
  • Zhang Y; Department of Emergency, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210000, China.
  • Xu S; Department of Emergency, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210000, China.
  • Xu J; Department of Emergency, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210000, China.
  • Xu F; Department of Emergency, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210000, China.
  • Lu G; Department of Emergency, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210000, China.
  • Zhou J; Department of Emergency, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210000, China.
  • Gu S; Department of Emergency, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210000, China; Department of Emergency, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210000, China. Electronic address: guss2926@njglyy.c
  • Wang J; Department of Emergency, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210000, China; Department of Emergency, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210000, China. Electronic address: wjgaogou@aliyun.c
Clin Chim Acta ; 548: 117467, 2023 Aug 01.
Article en En | MEDLINE | ID: mdl-37399884
BACKGROUND: Early evaluation of the severity of sepsis and estimation of its prognosis remains one of the main challenges in current therapeutic strategies. This study aimed to evaluate the prognostic value of plasma 7-ketocholesterol (7-KC) in sepsis. METHODS: We retrospectively measured by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) the plasma 7-KC concentration in 176 patients with sepsis and 90 healthy volunteers. A multivariate Cox proportional hazard model was introduced to identify independent factors, including plasma 7-KC and clinical features, for the 28-day mortality of sepsis, and a nomogram for predicting the 28-day mortality of sepsis was established. Decision curve analysis (DCA) was performed to assess the prediction model of death risk of sepsis. RESULTS: The area under the curve (AUC) of plasma 7-KC in diagnosing sepsis was 0.899 (95% CI = 0.862-0.935, P < 0.001), while it was 0.830 (95% CI = 0.764-0.894, P < 0.001) in diagnosing septic shock. The AUCs of plasma 7-KC in predicting the survival of sepsis patients in the training cohort and the test cohort were 0.770 (95% CI = 0.692-0.848, P < 0.05) and 0.869 (95% CI = 0.763-0.974, P < 0.05), respectively. In addition, high plasma 7-KC expression predicts poor prognosis in sepsis. Then, 7-KC and platelet count were identified as the two factors with significant differences by a multivariate Cox proportional hazard model, and the 28-day mortality probability ranged from 0.002 to 0.985 and was assessed using a nomogram. DCA results revealed that the combination of plasma 7-KC and platelet count showed the best prognostic efficiency of the risk threshold compared to a single factor in both the training cohort and test cohort. CONCLUSIONS: Collectively, the elevated plasma 7-KC level is an indicator of sepsis and was identified as a prognostic indicator for sepsis patients, providing a landscape for predicting survival in early sepsis with potential clinical utility.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Choque Séptico / Sepsis Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Chim Acta Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Choque Séptico / Sepsis Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Chim Acta Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Países Bajos