title: May thrombopoietin be a useful marker of sepsis severity assessment in patients with SIRS entering the emergency department?
abstract: BACKGROUND
  Thrombopoietin (TPO), a growth factor primarily involved in regulating thrombopoiesis, has been recently implicated in the pathogenesis of sepsis. TPO levels are, indeed, greatly increased in patients with sepsis compared to control subjects, and correlate with sepsis severity. The aim of this study was to evaluate TPO as predictive biomarker of sepsis and of sepsis severity in patients entering the emergency department (ED) with systemic inflammatory response syndrome (SIRS).
  
  
  METHODS
  This was a prospective observational study. Ours is a sub-study of the 'Need-speed trial', a multi-center observational study involving six Italian centers affiliated to the GREAT Italian Network. TPO was measured by ELISA.
  
  
  RESULTS
  We enrolled 13 patients with SIRS (6 with acute pancreatitis, 3 with acute heart failure, 1 with pulmonary embolism, and 3 with allergic reactions), and 40 patients with sepsis, eight of whom had severe sepsis and three septic shock. TPO was significantly higher in patients with sepsis than with SIRS. In addition, TPO was higher in patients with severe sepsis than with sepsis, and in patients with septic shock than with severe sepsis, although these differences did not reach the statistical significance.
  
  
  CONCLUSIONS
  Our preliminary results suggest that TPO may have the potential to be considered a promising early biomarker for both the diagnosis of sepsis and the assessment of sepsis severity in patients with SIRS entering the ED.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Segre
authors.forename: Luca
authors.initials: L
authors.lastname: Pigozzi
authors.forename: Davide
authors.initials: D
authors.lastname: Lison
authors.forename: Emanuele
authors.initials: E
authors.lastname: Pivetta
authors.forename: Ornella
authors.initials: O
authors.lastname: Bosco
authors.forename: Barbara
authors.initials: B
authors.lastname: Vizio
authors.forename: Umberto
authors.initials: U
authors.lastname: Suppo
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Turvani
authors.forename: Fulvio
authors.initials: F
authors.lastname: Morello
authors.forename: Stefania
authors.initials: S
authors.lastname: Battista
authors.forename: Corrado
authors.initials: C
authors.lastname: Moiraghi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Montrucchio
authors.forename: Enrico
authors.initials: E
authors.lastname: Lupia
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis*; D013926:Thrombopoietin / Q000097:blood*
chemical_list: D015415:Biomarkers; D013926:Thrombopoietin