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Soluble sTREM-1 as a prognostic biomarker of mortality in ventilator-associated Pneumonia: A prospective

Aishwarya Revanesh Aladakatti1, B S Jayaraj1, S K Chaya1

  • 1Department of Respiratory Medicine, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.

Respiratory Medicine
|October 29, 2025
PubMed
Abstract

Insights

Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) shows strong prognostic value for ventilator-associated pneumonia (VAP) outcomes. Elevated sTREM-1 levels in ICU patients predict mortality, improving risk stratification when combined with clinical scores.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Biomarker Research

Background:

  • Ventilator-associated pneumonia (VAP) is a significant cause of ICU morbidity and mortality.
  • Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) is an inflammatory marker with potential for assessing infection severity.
  • The prognostic utility of sTREM-1 in VAP requires further investigation.

Purpose of the Study:

  • To evaluate the prognostic value of serum sTREM-1 levels in patients with VAP.
  • To compare the prognostic accuracy of sTREM-1 with established clinical severity scores.
  • To assess the additive value of sTREM-1 in combination with clinical scores for VAP prognosis.

Main Methods:

  • Prospective observational study of 80 adult VAP patients (40 survivors, 40 non-survivors) in a tertiary care ICU.
  • Measurement of serum sTREM-1 levels via ELISA within 24 hours of VAP diagnosis.
  • Analysis included ROC curves, Cox regression, and Kaplan-Meier survival analysis, correlating sTREM-1 with clinical and inflammatory markers.

Main Results:

  • Non-survivors exhibited significantly higher sTREM-1 levels than survivors (17.3 vs. 7.2 pg/mL).
  • sTREM-1 correlated positively with CRP, D-dimer, and APACHE II, and negatively with PaO2/FiO2 and albumin.
  • sTREM-1 demonstrated strong prognostic accuracy (AUC 0.800), comparable to APACHE II (AUC 0.825); combined use improved AUC to 0.945.

Conclusions:

  • Serum sTREM-1 is a valuable early prognostic biomarker for VAP.
  • sTREM-1 offers additive prognostic value beyond established clinical scoring systems.
  • Integrating sTREM-1 with clinical scores can enhance risk stratification and guide ICU management decisions.
Keywords:
Centers for Disease Control and Prevention criteria (CDC)Intensive care units (ICUs)Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1)Ventilator-associated pneumonia (VAP)

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