Prognostic value of endotoxin activity assay in patients with severe sepsis after cardiac surgery

To evaluate the prognostic value of endotoxin activity assay (EAA) in adult patients with suspected or proven severe sepsis after cardiac surgery

Blood samples taken from 81 patients immediately after the diagnosis of severe sepsis were tested with the EAA. Patients were divided into 3 groups: low (<0.4, n = 20), moderate (0.4-0.59, n = 35) and high (≥0.6, n = 26) EAA levels.

Gram-negative bacteraemia was found in 19/55 (35%) of cases with ЕАА <0.6 and in 11/26 (42%) of cases with higher ЕАА, p = 0.67. Mortality at 28 days in Groups 1, 2 and 3 was 20%, 43% and 54%, respectively. Patients with an EAA higher than 0.65 had a higher 28-day mortality than those with lower EAA values (18/26 - 69% vs. 19/55 - 34.5%; p = 0.0072). ROC analysis for the prediction of 28-day mortality revealed an AUC for APACHE II scores, EAA and PCT of 0.81, 0.73 and 0.66, respectively.

EАА might be useful for recognising patients who have an increased risk of mortality due to severe sepsis.