• Emanuela Biagioni, Claudia Venturelli, David J Klein, Marta Buoncristiano, Fabio Rumpianesi, Stefano Busani, Laura Rinaldi, Abele Donati, and Massimo Girardis.
• Anaesthesia and Intensive Care Unit, University Hospital of Modena, L.go del Pozzo 71, 41100 Modena, Italy.
• J Crit Care. 2013 Oct 1;28(5):612-7.

PurposeThe aim of this prospective observational study was to evaluate in patients with sepsis not requiring intensive care unit admission the relationship between the levels of endotoxin activity assay (EAA) early after sepsis recognition and the risk of development of organ dysfunction (OD).MethodsEndotoxin activity assay levels were drawn immediately after sepsis identification (baseline) and at 6, 24, and 48 hours postbaseline in 50 patients with signs of sepsis of a duration of less than 24 hours. An EAA 0.60 units or greater was considered as highly elevated.ResultsLogistic regression showed independent association between EAA levels at baseline and the appearance of new OD (adjusted odd ratio, 2.41; 95% confidence interval, 1.18-4.90; P<.05). Fifteen patients (30%) who developed new OD after baseline had at least 1 EAA level 0.60 or greater. The adjusted linear regression analysis showed that across the 4 time points, EAA levels were significantly higher in patients who developed new OD (0.11; 95% confidence interval, 0.01-0.20; P<.05).ConclusionsEndotoxin activity assay levels 0.60 or greater early after sepsis diagnosis in patients not requiring intensive care unit admission predict risk of development of new organ dysfunction. High EAA levels in the first 48 hours of recognition of sepsis are also predictive of risk of deterioration.Copyright © 2013 Elsevier Inc. All rights reserved.

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