Does serum lactate combined with soluble endothelial selectins at ICU admission predict sepsis development?

Abstract

Aim: 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.

Patients and 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).

Conclusion: In our patient cohort, combining sE- and sP-selectin with serum lactate offers better prognostic value for sepsis development during ICU hospitalization.

Keywords: Lactate; critically-ill; prognostic; selectin; sepsis.