title: Does serum lactate combined with soluble endothelial selectins at ICU admission predict sepsis development?
abstract: OBJECTIVE
  We sought to determine for serum lactate its specificity and sensitivity in sepsis development prognosis in critically-ill, non-septic patients. Additionally, we evaluated whether sE-selectin or sP-selectin add prognostic value to lactate in sepsis.
  
  
  METHODS
  Using a cohort previously studied in another context, in this retrospective investigation we plotted receiver operating characteristic (ROC) curves using sepsis development as the classification variable and serum lactate levels and their linear combinations with soluble sE-selectin and/or sP-selectin levels at intensive care unit (ICU) admission, as prognostic variables.
  
  
  RESULTS
  Lactate levels combined with sE- and sP-selectin levels have the best prognostic accuracy showing a sensitivity and specificity of 76% and 84%, respectively, and an area under the curve (AUC) at 0.854 (95% confidence interval (CI)=0.775-0.932; p<0.001).
  
  
  CONCLUSIONS
  In our patient cohort, combining sE- and sP-selectin with serum lactate offers better prognostic value for sepsis development during ICU hospitalization.
authors: First Department of Critical Care Medicine and Pulmonary Services, GP Livanos and M Simou Laboratories, Medical School of Athens University, Evangelismos Hospital, Athens, Greece.
authors: Alice G
authors: AG
authors: Vassiliou
authors: First Department of Critical Care Medicine and Pulmonary Services, Medical School of Athens University, Evangelismos Hospital, Athens, Greece.
authors: Zafeiria
authors: Z
authors: Mastora
authors: First Department of Critical Care Medicine and Pulmonary Services, Medical School of Athens University, Evangelismos Hospital, Athens, Greece.
authors: Edison
authors: E
authors: Jahaj
authors: First Department of Critical Care Medicine and Pulmonary Services, GP Livanos and M Simou Laboratories, Medical School of Athens University, Evangelismos Hospital, Athens, Greece.
authors: Antonia
authors: A
authors: Koutsoukou
authors: First Department of Critical Care Medicine and Pulmonary Services, GP Livanos and M Simou Laboratories, Medical School of Athens University, Evangelismos Hospital, Athens, Greece Second Department of Critical Care, Medical School of Athens University, Attikon Hospital, Athens, Greece.
authors: Stylianos E
authors: SE
authors: Orfanos
authors: First Department of Critical Care Medicine and Pulmonary Services, GP Livanos and M Simou Laboratories, Medical School of Athens University, Evangelismos Hospital, Athens, Greece First Department of Critical Care Medicine and Pulmonary Services, Medical School of Athens University, Evangelismos Hospital, Athens, Greece akotanid@med.uoa.gr.
authors: Anastasia
authors: A
authors: Kotanidou
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers; D019040:E-Selectin / Q000097:blood*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007773:Lactates / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D019040:E-Selectin; D007773:Lactates
keywords: Lactate; critically-ill; prognostic; selectin; sepsis