Diagnostic and prognostic value of plasma gelsolin in multiorgan failure in patients with sepsis

Theodor Bilharz Research Institute

Bibliographic Information

Authors: El-Maghraby A.; Mowafy H.; Omer E.; El-Akabawy H.; Nessim I.

Journal: Open Access Macedonian Journal of Medical Sciences

Publisher: Open Access Macedonian Journal of Medical Sciences

Publication Date: 10 January 2021

Volume / Issue: Volume 9

Pages: 29–35

ISSN: 18579655

DOI: 10.3889/oamjms.2021.5281

Scopus: View on Scopus

Document Type: Article

Access: All Open Access; Gold Open Access

Authors and Affiliations

El-Maghraby A., Department of Critical Care Medicine, Theodor Bilharz Research Institute, Cairo, Egypt; Mowafy H., Department of Critical Care Medicine, Cairo University, Cairo, Egypt; Omer E., Department of Critical Care Medicine, Cairo University, Cairo, Egypt; El-Akabawy H., Department of Critical Care Medicine, Cairo University, Cairo, Egypt; Nessim I., Clinical Chemistry Unit, Theodor Bilharz Research Institute, Cairo, Egypt

Abstract

AIM: The aim of this work is to investigate the clinical value of gelsolin plasma concentration in the diagnosis of sepsis and investigate the relationship between gelsolin plasma concentration and the severity of organ dysfunction assessed by the acute physiology and chronic health evaluation (APACHE II) and SOFA scores, and to study the mortality predictive power of gelsolin plasma concentration. METHODS: We analyzed data of patients admitted with sepsis (n = 46) for 5 days. Age-and sex-matched non-specific intensive care unit (ICU) patients (n = 18) served as controls. Septic patients were then divided according to severity of disease to patients with sepsis, severe sepsis, and septic shock. Besides plasma gelsolin (pGSN) classical laboratory parameters and clinical scores (APACHE II and SOFA) were also assessed. RESULTS: Septic patients showed significantly decreased 1st-day GSN levels (170.9 ± 74.3 mg/l) compared to non-septic critically ill patients (225.9 ± 84.5 mg/l, p < 0.05). Furthermore, patients with septic shock had lower gelsolin plasma concentration than with severe sepsis and with sepsis (p < 0.05); furthermore, non-survivors had significantly lower GSN levels compared to survivors (p < 0.05). Septic patients had higher APACHE II and SOFA scores. Lower GSN level was significantly correlated with the development of multiple organ dysfunction syndrome and fatal outcome, also, patients with lower GSN level had longer ICU stay, APACHE II, and SOFA scores. APACHE II score has shown best ability to predict mortality with AUC 0.913 followed by PCT with AUC 0.828. pGSN was the least in the ability to predict mortality with AUC only 0.378 despite significant difference between pGSN levels between survivals and non-survivals. CONCLUSIONS: pGSN might serve as efficient complementary marker in sepsis. However, the prognostic role of pGSN in mortality requires further investigation in larger studies. © 2021 Ahmed El-Maghraby, Hossam Mowafy, Emad Omer, Hazem El-Akabawy, Iris Nessim.

Keywords

Acute physiology and Chronic health Evaluation II; Gelsolin; Sepsis; Septic shock; Sequential Organ Failure Assessment (SOFA) score; alanine aminotransferase; albumin; aspartate aminotransferase; bilirubin; creatinine; urea; adult; APACHE; area under the curve; Article; blood cell count; blood gas analysis; blood sampling; breathing rate; computer assisted tomography; controlled study; diagnostic test accuracy study; diastolic blood pressure; disease severity; echography; enzyme linked immunosorbent assay; female; heart rate; hospital mortality; hospitalization; human; hypotension; intensive care unit; kidney function; kidney function test; length of stay; leukocyte count; male; mean arterial pressure; multicenter study; multiple organ failure; neutrophil count; observational study; outcome assessment; predictive value; prospective study; receiver operating characteristic; resuscitation; sensitivity and specificity; Sequential Organ Failure Assessment Score; spectrophotometry; survivor; systolic blood pressure; urea blood level; urinalysis

Citation Information

Scopus Citations: 1

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