Increased Serum Concentrations of TNF-Like Weak Inducer of Apoptosis Predict Higher 28-Day Mortality in Patients with Sepsis

We performed the current study to explore potential predictive value of serum Tumor Necrosis Factor- (TNF-) like weak inducer of apoptosis (TWEAK) concentrations for 28-day mortality in patients with sepsis. Adult septic patients (age≥18 years) admitted to a general ICU between November 2016 and Oct...

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Main Authors: Ying Guo, Manyi Ren, Lili Ge, Chao Sun, Rui Li, Cheng’en Ma, Shujian Sui
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Emergency Medicine International
Online Access:http://dx.doi.org/10.1155/2019/7238705
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author Ying Guo
Manyi Ren
Lili Ge
Chao Sun
Rui Li
Cheng’en Ma
Shujian Sui
author_facet Ying Guo
Manyi Ren
Lili Ge
Chao Sun
Rui Li
Cheng’en Ma
Shujian Sui
author_sort Ying Guo
collection DOAJ
description We performed the current study to explore potential predictive value of serum Tumor Necrosis Factor- (TNF-) like weak inducer of apoptosis (TWEAK) concentrations for 28-day mortality in patients with sepsis. Adult septic patients (age≥18 years) admitted to a general ICU between November 2016 and October 2017 were consecutively included in our prospective observational study. TWEAK concentrations were detected in septic patients and healthy controls. Dynamic changes of TWEAK concentrations between 1st day and 3rd day of admission to ICU (ΔTWEAK concentrations) were also measured. A total of 79 septic patients were included and 19 of them (24.1%) died after a follow-up period of 28 days. We identified arterial lactate, NT-proBNP, and male gender as independent factors for 28-day mortality of patients with sepsis. The serum levels of TWEAK were significantly lower in septic patients compared to controls (417.4 ± 196.7 pg/ml versus 1243.8 ± 174.3 pg/ml, p<0.001). We found a positive correlation between TWEAK concentrations and SOFA score (Spearman correlation coefficient 0.235, p=0.037). Area under the receiver operating characteristic curve (AUROC) of ΔTWEAK concentrations for 28-day mortality was 0.754 (95% CI 0.645–0.844). We also evaluated the diagnostic performance of combinative index (ΔTWEAK concentrations and lactate) and obtained an AUROC of 0.860 (95% CI 0.763-0.928). In conclusion, our study found lower TWEAK concentrations in septic patients than those in healthy controls. Furthermore, the increased TWEAK concentrations during disease process predict higher 28-day mortality in septic patients. Dynamic changes of TWEAK should be an important supplement for current prognostic markers.
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spelling doaj-art-ce6ddfe8a3be4a96ac2e8e44232ff1012025-08-20T02:19:29ZengWileyEmergency Medicine International2090-28402090-28592019-01-01201910.1155/2019/72387057238705Increased Serum Concentrations of TNF-Like Weak Inducer of Apoptosis Predict Higher 28-Day Mortality in Patients with SepsisYing Guo0Manyi Ren1Lili Ge2Chao Sun3Rui Li4Cheng’en Ma5Shujian Sui6Department of Intensive Care Unit, The Second Hospital of Shandong University, Jinan 250033, ChinaDepartment of Cardiology, Qianfoshan Hospital Affiliated to Shandong University, Jinan 250014, ChinaDepartment of Cardiovascular Medicine, The Second Hospital of Shandong University, Jinan 250033, ChinaCentral Research Laboratory, The Second Hospital of Shandong University, Jinan 250033, ChinaDepartment of Emergency, The Second Hospital of Shandong University, Jinan 250033, ChinaDepartment of Intensive Care Unit, The Second Hospital of Shandong University, Jinan 250033, ChinaDepartment of Cardiovascular Medicine, The Second Hospital of Shandong University, Jinan 250033, ChinaWe performed the current study to explore potential predictive value of serum Tumor Necrosis Factor- (TNF-) like weak inducer of apoptosis (TWEAK) concentrations for 28-day mortality in patients with sepsis. Adult septic patients (age≥18 years) admitted to a general ICU between November 2016 and October 2017 were consecutively included in our prospective observational study. TWEAK concentrations were detected in septic patients and healthy controls. Dynamic changes of TWEAK concentrations between 1st day and 3rd day of admission to ICU (ΔTWEAK concentrations) were also measured. A total of 79 septic patients were included and 19 of them (24.1%) died after a follow-up period of 28 days. We identified arterial lactate, NT-proBNP, and male gender as independent factors for 28-day mortality of patients with sepsis. The serum levels of TWEAK were significantly lower in septic patients compared to controls (417.4 ± 196.7 pg/ml versus 1243.8 ± 174.3 pg/ml, p<0.001). We found a positive correlation between TWEAK concentrations and SOFA score (Spearman correlation coefficient 0.235, p=0.037). Area under the receiver operating characteristic curve (AUROC) of ΔTWEAK concentrations for 28-day mortality was 0.754 (95% CI 0.645–0.844). We also evaluated the diagnostic performance of combinative index (ΔTWEAK concentrations and lactate) and obtained an AUROC of 0.860 (95% CI 0.763-0.928). In conclusion, our study found lower TWEAK concentrations in septic patients than those in healthy controls. Furthermore, the increased TWEAK concentrations during disease process predict higher 28-day mortality in septic patients. Dynamic changes of TWEAK should be an important supplement for current prognostic markers.http://dx.doi.org/10.1155/2019/7238705
spellingShingle Ying Guo
Manyi Ren
Lili Ge
Chao Sun
Rui Li
Cheng’en Ma
Shujian Sui
Increased Serum Concentrations of TNF-Like Weak Inducer of Apoptosis Predict Higher 28-Day Mortality in Patients with Sepsis
Emergency Medicine International
title Increased Serum Concentrations of TNF-Like Weak Inducer of Apoptosis Predict Higher 28-Day Mortality in Patients with Sepsis
title_full Increased Serum Concentrations of TNF-Like Weak Inducer of Apoptosis Predict Higher 28-Day Mortality in Patients with Sepsis
title_fullStr Increased Serum Concentrations of TNF-Like Weak Inducer of Apoptosis Predict Higher 28-Day Mortality in Patients with Sepsis
title_full_unstemmed Increased Serum Concentrations of TNF-Like Weak Inducer of Apoptosis Predict Higher 28-Day Mortality in Patients with Sepsis
title_short Increased Serum Concentrations of TNF-Like Weak Inducer of Apoptosis Predict Higher 28-Day Mortality in Patients with Sepsis
title_sort increased serum concentrations of tnf like weak inducer of apoptosis predict higher 28 day mortality in patients with sepsis
url http://dx.doi.org/10.1155/2019/7238705
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