• Dong Won Park, Dong Shin Kwak, Yun Young Park, Youjin Chang, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Dong-Keun Song, and Sang-Bum Hong.
• Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea.
• J Crit Care. 2014 Oct 1;29(5):882.e5-11.

PurposeThe purpose of this study is to investigate the effect of serial lysophosphatidylcholine (LPC) measurement on 28-day mortality prediction in patients with severe sepsis or septic shock admitted to the medical intensive care unit (ICU).MethodsThis is a prospective observational study of 74 ICU patients in a tertiary hospital. Serum LPC, white blood cell, C-reactive protein, and procalcitonin (PCT) levels were measured at baseline (day 1 of enrollment) and day 7. The LPC concentrations were compared with inflammatory markers using their absolute levels and relative changes.ResultsThe LPC concentration on day 7 was significantly lower in nonsurvivors than in survivors (68.45 ± 42.36 μmol/L and 99.76 ± 73.65 μmol/L; P = .04). A decreased LPC concentration on day 7 to its baseline as well as a sustained high concentration of PCT on day 7 at more than 50% of its baseline value was useful for predicting the 28-day mortality. Prognostic utility was substantially improved when combined LPC and PCT criteria were applied to 28-day mortality outcome predictions. Furthermore, LPC concentrations increased over time in patients with appropriate antibiotics but not in those with inappropriate antibiotics.ConclusionsSerial measurements of LPC help in the prediction of 28-day mortality in ICU patients with severe sepsis or septic shock.Copyright © 2014 Elsevier Inc. All rights reserved.

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