title: Impact of serial measurements of lysophosphatidylcholine on 28-day mortality prediction in patients admitted to the intensive care unit with severe sepsis or septic shock.
abstract: OBJECTIVE
  The 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).
  
  
  METHODS
  This 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.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  Serial measurements of LPC help in the prediction of 28-day mortality in ICU patients with severe sepsis or septic shock.
authors: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea.
authors: Dong Won
authors: DW
authors: Park
authors: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea.
authors: Dong Shin
authors: DS
authors: Kwak
authors: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors: Yun Young
authors: YY
authors: Park
authors: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors: Youjin
authors: Y
authors: Chang
authors: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors: Jin Won
authors: JW
authors: Huh
authors: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors: Chae-Man
authors: CM
authors: Lim
authors: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors: Younsuck
authors: Y
authors: Koh
authors: Department of Pharmacology, College of Medicine, Institute of Natural Medicine, Hallym University, Chunchon, South Korea.
authors: Dong-Keun
authors: DK
authors: Song
authors: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address: sbhong@amc.seoul.kr.
authors: Sang-Bum
authors: SB
authors: Hong
mesh_terms: D018806:APACHE; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D018655:Lymphocyte Count; D008244:Lysophosphatidylcholines / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood; D018805:Sepsis / Q000097:blood* / Q000401:mortality*; D012772:Shock, Septic / Q000097:blood / Q000401:mortality; D013997:Time Factors
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D008244:Lysophosphatidylcholines; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide
keywords: Intensive care unit; Lysophosphatidylcholine; Mortality; Septic shock; Severe sepsis