Relation of Procollagen Type III Amino Terminal Propeptide Level to Sepsis Severity in Pediatrics

Area of Science:

• Biomarker Discovery
• Pediatric Critical Care
• Sepsis Pathophysiology

Background:

• Sepsis is a leading cause of mortality in pediatric intensive care units (PICUs).
• Accurate diagnosis of sepsis severity and prediction of mortality are crucial for effective management.
• The diagnostic and prognostic value of procollagen Type III amino-terminal propeptide (PIIINP) in pediatric sepsis requires further evaluation.

Purpose of the Study:

• To assess the utility of serum PIIINP as a biomarker for diagnosing sepsis severity in critically ill children.
• To determine the correlation between PIIINP levels and mortality risk in pediatric sepsis patients.

Main Methods:

• A prospective study involving 170 critically ill children in the PICU and 100 controls.
• Serum PIIINP levels were measured at admission for patients and controls.
• Pediatric Risk of Mortality (PRISM) score was calculated for all pediatric patients.

Main Results:

• PIIINP levels were significantly elevated in patients with sepsis, severe sepsis, and septic shock compared to controls (p < 0.001).
• PIIINP levels were progressively higher in severe sepsis and septic shock than in sepsis alone (p < 0.001).
• Non-survivors exhibited significantly higher PIIINP levels than survivors (p < 0.016), with an AUC of 0.651 for mortality prediction (cutoff 490.4 ng/mL).
• ROC analysis showed an AUC of 0.833 for PIIINP in predicting sepsis (cutoff 103.3 ng/mL; sensitivity 88%, specificity 82%).

Conclusions:

• Elevated serum PIIINP levels are indicative of sepsis in critically ill children.
• PIIINP levels significantly correlate with sepsis severity (severe sepsis, septic shock) and increased mortality risk.
• PIIINP is a promising biomarker for assessing pediatric sepsis severity and predicting patient outcomes.