Serum Thrombomodulin Level Can Predict Mortality in Patients With Sepsis?

Area of Science:

• Biochemistry
• Critical Care Medicine
• Pathophysiology

Background:

• Thrombomodulin (TM) is a glycoprotein on endothelial cells involved in various biochemical pathways.
• Soluble thrombomodulin (sTM) is a predominant form found in biological fluids.
• TM plays a critical role in the protein C system and sepsis pathogenesis.

Purpose of the Study:

• To determine serum sTM levels in sepsis and septic shock patients.
• To assess the relationship between sTM levels and in-hospital survival outcomes.
• To validate sTM as a predictor of mortality in sepsis.

Main Methods:

• Prospective observational study of 63 sepsis/septic shock patients.
• Sepsis 3 criteria used for diagnosis.
• Serum sTM levels measured and compared between sepsis, septic shock, survival, and fatal groups.

Main Results:

• Septic shock and fatal groups exhibited significantly higher sTM levels compared to sepsis and survival groups.
• sTM demonstrated strong predictive power for mortality (AUC=0.803), comparable to SOFA and superior to APACHE II and DIC scores.
• Elevated lactate and creatinine were observed in septic shock and fatal groups.

Conclusions:

• Serum sTM is a reliable biomarker for predicting sepsis severity and mortality.
• Elevated sTM levels are associated with increased mortality risk in sepsis patients.
• sTM can aid in clinical decision-making for critically ill sepsis patients.