title: [Prognostic value of lipopolysaccharide binding protein and procalcitonin in patients with severe sepsis and septic shock admitted to intensive care].
abstract: OBJECTIVE
  1) 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.
  
  
  METHODS
  A single-center, prospective observational study was carried out.
  
  
  METHODS
  Intensive Care unit of a university hospital.
  
  
  METHODS
  One hundred severe sepsis and septic shock patients were included.
  
  
  METHODS
  Demographic data, APACHE II and SOFA scores, PCT and LBP levels on admission and after 48 hours, and in-hospital mortality.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  LBP 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.
authors: Servicio de Análisis Clínicos, Hospital Universitario Santa Lucía, Cartagena, España. Electronic address: guadianarom@yahoo.es.
authors: L M
authors: LM
authors: García de Guadiana-Romualdo
authors: Servicio de Medicina Intensiva, Hospital Universitario Santa Lucía, Cartagena, España.
authors: S
authors: S
authors: Rebollo-Acebes
authors: Servicio de Análisis Clínicos, Hospital Universitario Santa Lucía, Cartagena, España.
authors: P
authors: P
authors: Esteban-Torrella
authors: Servicio de Medicina Intensiva, Hospital Universitario Santa Lucía, Cartagena, España.
authors: R
authors: R
authors: Jiménez-Sánchez
authors: Servicio de Análisis Clínicos, Hospital Universitario Santa Lucía, Cartagena, España.
authors: A
authors: A
authors: Hernando-Holgado
authors: Servicio de Medicina Intensiva, Hospital Universitario Santa Lucía, Cartagena, España.
authors: A
authors: A
authors: Ortín-Freire
authors: Servicio de Microbiología y Parasitología, Hospital Universitario Santa Lucía, Cartagena, España.
authors: M
authors: M
authors: Viqueira-González
authors: Servicio de Medicina Interna, Hospital Universitario Santa Lucía, Cartagena, España.
authors: J
authors: J
authors: Trujillo-Santos
authors: Servicio de Análisis Clínicos, Hospital Universitario Santa Lucía, Cartagena, España.
authors: E
authors: E
authors: Jiménez Santos
authors: Servicio de Análisis Clínicos, Hospital Universitario Santa Lucía, Cartagena, España.
authors: J
authors: J
authors: Pedregosa Díaz
authors: Servicio de Análisis Clínicos, Hospital Universitario Santa Lucía, Cartagena, España.
authors: M D
authors: MD
authors: Albaladejo-Otón
authors: Servicio de Medicina Intensiva, Hospital Universitario Santa Lucía, Cartagena, España.
authors: J M
authors: JM
authors: Allegue-Gallego
mesh_terms: D018806:APACHE; D000209:Acute-Phase Proteins; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D002352:Carrier Proteins / Q000097:blood*; D005260:Female; D017052:Hospital Mortality; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D010343:Patient Admission / Q000706:statistics & numerical data; D011379:Prognosis; D012372:ROC Curve; D018805:Sepsis / Q000097:blood* / Q000401:mortality; D012772:Shock, Septic / Q000097:blood / Q000401:mortality; D013030:Spain / Q000453:epidemiology; D000099231:Lipopolysaccharide-Binding Protein
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D002116:Calcitonin; D002352:Carrier Proteins; D008562:Membrane Glycoproteins; D000099231:Lipopolysaccharide-Binding Protein
keywords: In-hospital mortality; Lipopolysaccharide binding protein; Mortalidad hospitalaria; Procalcitonin; Procalcitonina; Prognosis; Pronóstico; Proteína fijadora de lipopolisacáridos; Sepsis