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Ulinastatin Treatment Associated with Lower Sepsis-Associated Encephalopathy Risk in Sepsis Patients: A Multicenter
Tingting Xu1, Qin Zhang2, Hang Ruan1
1Department of Critical Care Medicine/Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Shock (Augusta, Ga.)
|June 30, 2026
Summary
Ulinastatin treatment significantly reduces the risk of sepsis-associated encephalopathy (SAE) in sepsis patients. Combining biomarkers like nitric oxide with clinical data improves early SAE prediction.
Area of Science:
- Critical Care Medicine
- Neurology
- Pharmacology
Background:
- Sepsis-associated encephalopathy (SAE) is a common complication of sepsis.
- Ulinastatin is used in Asia for sepsis management but its role in preventing SAE is not well-established.
Purpose of the Study:
- To investigate the association between ulinastatin treatment and SAE incidence.
- To explore combined biomarkers for early SAE prediction.
Main Methods:
- Dual-cohort study (retrospective and prospective validation) with 2,200 and 534 sepsis patients, respectively.
- Logistic regression, propensity score matching, and biomarker analysis were used.
- Evaluated clinical outcomes and combined biomarkers (nitric oxide, glucose/HDL ratio, SOFA, lactate) for SAE prediction.
Main Results:
- Ulinastatin administration was significantly associated with reduced SAE risk in both cohorts (multivariate OR 0.603, P < 0.001; adjusted OR 0.491, P = 0.004).
- Individual biomarkers had limited predictive value for SAE (AUC < 0.70).
- Combined biomarkers significantly improved SAE prediction accuracy (max AUC 0.726).
Conclusions:
- Ulinastatin treatment is associated with a lower incidence of SAE in sepsis patients.
- This suggests ulinastatin as a potential therapeutic strategy for SAE prevention.
- Combined biomarkers offer improved early risk stratification for SAE.
