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Published on: October 31, 2012
Clinical Value of Galectin-9, Soluble TREM-1, and Soluble CD25 Among Critically Ill Patients with Organ Failure in
Uihwan Kim1, Sijin Lee1, Kap Su Han1
1Department of Emergency Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea.
Insights
This study found that galectin-9 (Gal-9), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), and soluble CD25 (sCD25) can help diagnose sepsis and predict mortality in critically ill patients. sCD25 is a key predictor of 30-day survival in sepsis patients.
Area of Science:
- Critical Care Medicine
- Biomarker Discovery
- Emergency Medicine
Background:
- Critically ill patients with organ failure present diagnostic and prognostic challenges.
- Galectin-9 (Gal-9), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), and soluble CD25 (sCD25) are potential biomarkers in critical illness.
Purpose of the Study:
- To investigate the clinical utility of Gal-9, sTREM-1, and sCD25 in diagnosing and predicting outcomes for critically ill patients with organ failure.
- To evaluate the diagnostic accuracy and prognostic value of these biomarkers in differentiating non-infectious organ failure, sepsis, and septic shock.
Main Methods:
- A cohort of 786 critically ill patients was analyzed, categorized into non-infectious organ failure (NIOF), sepsis, and septic shock groups.
- Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis.
- Prognostic value was determined through Kaplan-Meier survival analysis and Cox proportional hazard modeling.
Main Results:
- Gal-9, sTREM-1, and sCD25 demonstrated significant diagnostic value in discriminating sepsis from NIOF and septic shock from sepsis (AUCs ranging from 0.555 to 0.781).
- Elevated levels of Gal-9, sTREM-1, and sCD25 were associated with significantly higher 30-day mortality in sepsis patients (p < 0.001 for all).
- Soluble CD25 was identified as an independent risk factor for 30-day mortality in patients with sepsis or septic shock.
Conclusions:
- Gal-9, sTREM-1, and sCD25 possess diagnostic and prognostic capabilities in critically ill patients with organ failure.
- sCD25 is a valuable predictor of 30-day mortality in sepsis patients.
- These biomarkers can serve as adjunct tools to aid clinicians in optimizing sepsis management strategies.
Abstract:
Background/Objectives: This study investigated clinical value of galectin-9 (Gal-9), a soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), and soluble CD25 (sCD25) among critically ill patients with organ failure in the emergency department. Methods: Overall, 786 patients were enrolled and classified into non-infectious organ failure (NIOF, n = 331), sepsis (n = 266), and septic shock (n = 189). The diagnostic value of Gal-9, sTREM-1, and sCD25 were evaluated by receiver operating characteristic curve analysis. The prognostic value of the biomarkers was evaluated using Kaplan-Meier survival curve and Cox proportional hazard model analyses. Results: Gal-9, sTREM-1, and sCD25 could discriminate sepsis from NIOF (Gal-9, area under the curve [AUC], 0.599-0.678; sTREM-1, AUC, 0.616-0.695; sCD25, AUC, 0.710-0.781) and septic shock from sepsis (Gal-9, AUC, 0.562-0.667; sTREM-1, AUC, 0.572-0.676; sCD25, AUC, 0.555-0.660), respectively. Sepsis patients with higher levels of biomarkers over their cut-off value showed higher 30-day mortality compared to those with lower levels below the cut-off value (Gal-9 ≥ 14,391.80 ng/L, p < 0.001; sTREM-1 ≥ 580.62 ng/L, p < 0.001; sCD25 ≥ 1639.29 ng/L, p < 0.001; respectively) (log-rank test). sCD25 is an independent risk factor for 30-day mortality in patients with sepsis or septic shock. Conclusions: Gal-9, sTREM-1, and sCD25 showed diagnostic and prognostic value in critically ill patients with organ failure. sCD25 can predict the 30-day mortality in patients with sepsis. Gal-9, sTREM-1, and sCD25 could serve as auxiliary biomarkers to support clinicians in effective sepsis management.
