title: Soluble receptor for advanced glycation end products predicts 28-day mortality in critically ill patients with sepsis.
abstract: OBJECTIVE
  Multiple biomarkers are used to assess sepsis severity and prognosis. Increased levels of the soluble receptor for advanced glycation end products (sRAGE) were previously observed in sepsis but also in end-organ injury without sepsis. We evaluated associations between sRAGE and (i) 28-day mortality, (ii) sepsis severity, and (iii) individual organ failure. Traditional biomarkers procalcitonin (PCT), C-reactive protein (CRP) and lactate served as controls.
  
  
  METHODS
  sRAGE, PCT, CRP, and lactate levels were observed on days 1 (D1) and 3 (D3) in 54 septic patients. We also assessed the correlation between the biomarkers and acute respiratory distress syndrome (ARDS), acute kidney injury (AKI) and acute heart failure.
  
  
  RESULTS
  There were 38 survivors and 16 non-survivors. On D1, non-survivors had higher sRAGE levels than survivors (p = 0.027). On D3, sRAGE further increased only in non-survivors (p < 0.0001) but remained unchanged in survivors. Unadjusted odds ratio (OR) for 28-day mortality was 8.2 (95% CI: 1.02-60.64) for sRAGE, p = 0.048. Receiver operating characteristic analysis determined strong correlation with outcome on D3 (AUC = 0.906, p < 0.001), superior to other studied biomarkers. sRAGE correlated with sepsis severity (p < 0.00001). sRAGE showed a significant positive correlation with PCT and CRP on D3. In patients without ARDS, sRAGE was significantly higher in non-survivors (p < 0.0001) on D3.
  
  
  CONCLUSIONS
  Increased sRAGE was associated with 28-day mortality in patients with sepsis, and was superior compared to PCT, CRP and lactate. sRAGE correlated with sepsis severity. sRAGE was increased in patients with individual organ failure. sRAGE could be used as an early biomarker in prognostication of outcome in septic patients.
authors.affiliation: Institute of Clinical Biochemistry and Laboratory Diagnostics.
authors.forename: Helena
authors.initials: H
authors.lastname: Brodska
authors.forename: Karin
authors.initials: K
authors.lastname: Malickova
authors.forename: Jiri
authors.initials: J
authors.lastname: Valenta
authors.forename: Anthony
authors.initials: A
authors.lastname: Fabio
authors.forename: Tomas
authors.initials: T
authors.lastname: Drabek
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016638:Critical Illness / Q000401:mortality; D005260:Female; D017127:Glycation End Products, Advanced / Q000097:blood*; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D017127:Glycation End Products, Advanced