• L M García de Guadiana-Romualdo, S Rebollo-Acebes, P Esteban-Torrella, R Jiménez-Sánchez, A Hernando-Holgado, A Ortín-Freire, M Viqueira-González, J Trujillo-Santos, E Jiménez Santos, J Pedregosa Díaz, M D Albaladejo-Otón, and J M Allegue-Gallego.
• Servicio de Análisis Clínicos, Hospital Universitario Santa Lucía, Cartagena, España. Electronic address: guadianarom@yahoo.es.
• Med Intensiva. 2015 May 1; 39 (4): 207-12.

Aims1) To assess the prognostic value of levels on admission and serial measurements of lipopolysaccharide binding protein (LBP) and procalcitonin (PCT) in relation to in-hospital mortality; and 2) to determine whether the addition of these parameters to severity scores (APACHE II and SOFA) is able to improve prognostic accuracy.DesignA single-center, prospective observational study was carried out.SettingIntensive Care unit of a university hospital.PatientsOne hundred severe sepsis and septic shock patients were included.Data CollectedDemographic data, APACHE II and SOFA scores, PCT and LBP levels on admission and after 48 hours, and in-hospital mortality.ResultsThe best area under the curve for predicting in-hospital mortality corresponded to APACHE II on admission and SOFA after 48 h (AUC ROC: 0.75 for both). PCT and LBP levels on admission and LBP clearance were not statistically different between in-hospital survivors and non-survivors. Only PCT clearance was higher among in-hospital survivors than in non-survivors (AUC ROC: 0.66). The combination of severity scores and PCT clearance did not result in superior areas under the curve.ConclusionsLBP and PCT levels on admission and LBP clearance showed no prognostic value in severe sepsis and septic shock patients. Only PCT clearance was predictive of in-hospital mortality. The prognostic accuracy was significantly better for APACHE on admission and SOFA after 48 h than for any of the analyzed biomarkers, and the addition of PCT clearance did not improve their prognostic value.Copyright © 2013 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

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