Prognostic value of plasma pentraxin 3 levels in patients with septic shock admitted to intensive care

Abstract

Objective: To evaluate the usefulness of a new marker, pentraxin, as a prognostic marker in septic shock patients. Materials and methods: Single-centre prospective observational study that included all consecutive patients 18 years or older who were admitted to the intensive care unit (ICU) with septic shock. Serum levels of procalcitonin (PCT), C reactive protein (CRP) and pentraxin (PTX3) were measured on ICU admission. Results: Seventy-five septic shock patients were included in the study. The best predictors of inhospital mortality were the severity scores: SAPS II (AUC = 0.81), SOFA (AUC = 0.79) and APACHE II (AUC = 0.73). The ROC curve for PTX3 (ng/mL) yielded an AUC of 0.70, higher than the AUC for PCT (0.43) and CRP (0.48), but lower than lactate (0.79). Adding PTX3 to the logistic model increased the predictive capacity in relation to SAPS II, SOFA and APACHE II for in-hospital mortality (AUC 0.814, 0.795, and 0.741, respectively). In crude regression models, significant associations were found between in-hospital mortality and PTX3. This positive association increased after adjusting for age, sex and immunosuppression: adjusted OR T3 for PTX3 = 7.83, 95% CI 1.35?45.49, linear P trend = 0.024. Conclusion: Our results support the prognostic value of a single determination of plasma PTX3 as a predictor of hospital mortality in septic shock patients.