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Abstract
Sepsis remains a critical problem with high mortality worldwide, but there is still a lack of reliable biomarkers. We aimed to evaluate the serum lysophosphatidylcholine (LPC) 16:0 as a biomarker of sepsis using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Patients admitted to intensive care unit at Severance Hospital from March 2017 through June 2018 were prospectively enrolled. The inclusion criteria were the fulfillment of at least two criteria of systemic inflammatory response syndrome (SIRS) or the presence of sepsis. Of the 127 patients, 14 had non-infectious SIRS, 41 had sepsis, and 72 had septic shock. The mean serum LPC 16:0 concentration (µmol/L) in non-infectious SIRS was significantly higher than in patients with sepsis and septic shock (101.1 vs. 48.92, p < 0.05; 101.1 vs. 25.88, p < 0.001, respectively). The area under the curve (AUC) predicting 28-day mortality using ΔLPC16:0 (D1-D0) levels was 0.7, which was comparable with the APACHE II score (AUC 0.692) and SOFA score (AUC 0.67). Mechanical ventilation, CRRT, lactate, Δ LPC16:0 (D1-D0) less than the cut-off value were significantly associated with 28-day mortality in multivariable analysis. Our results suggest that LPC16:0 could be a useful biomarker for sepsis diagnosis and mortality prediction in ICU patients.
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1 Yonsei University College of Medicine, Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yongin-si, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
2 Yonsei University College of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Institute of Chest Diseases, Severance Hospital, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
3 Yonsei University, Department of Materials Science and Engineering, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
4 Yonsei University College of Medicine, Department of Laboratory Medicine, Severance Hospital, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
5 Yonsei University College of Medicine, Department of Internal Medicine and AIDS Research Institute, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)