Multi-Marker Approach in Sepsis: A Clinical Role Beyond SOFA Score

Area of Science:

• Biomarkers and diagnostics
• Sepsis research
• Clinical utility assessment

Background:

• Procalcitonin (PCT), presepsin (PSEP), interferon-λ3 (IFN-λ3), and bioactive adrenomedullin (bio-ADM) are emerging sepsis biomarkers.
• Assessing their combined diagnostic and prognostic value is crucial for clinical application.

Purpose of the Study:

• To evaluate the clinical utility of a multi-marker approach using PCT, PSEP, IFN-λ3, and bio-ADM in patients with suspected sepsis.
• To compare the performance of this multi-marker strategy against the Sequential Organ Failure Assessment (SOFA) score for sepsis diagnosis and in-hospital mortality prediction.

Main Methods:

• Conducted a study on 248 patients with suspected sepsis.
• Measured PCT, PSEP, IFN-λ3, and bio-ADM levels.
• Analyzed diagnostic and prognostic performance using receiver operating characteristic curves (AUC) and survival analyses.
• Compared multi-marker approach with SOFA score.

Main Results:

• All four biomarkers demonstrated significant diagnostic performance (AUC = 0.61-0.95).
• The multi-marker approach significantly increased sepsis detection rates and outperformed the SOFA score in predicting in-hospital mortality (mortality rate 58.3% vs. 31.3%).
• The multi-marker approach showed enhanced prognostic value in patients aged ≥75 years.

Conclusions:

• Individual biomarkers hold clinical utility for suspected sepsis.
• A multi-marker approach provides complementary value to the SOFA score.
• This combined strategy offers superior prognostic performance, particularly in elderly patients (≥75 years).