Correlation between Sequential Organ Failure Assessment scores and indicators of inflammation and infection in patients with sepsis

Abstract

Abstract Objective and design We aimed to explore the correlation between eight plasma biomarkers and the Sequential Organ Failure Assessment (SOFA) score in sepsis. Subjects Adult medical non-trauma patients with sepsis (n = 450) were enrolled in the University of Pittsburgh Acute Lung Injury Registry (ALIR) between October 2011 and January 2018. The final cohort consisted of 153 patients (SOFA score > 2). Methods PTX-3 was analyzed using multiple statistical tests along with the SOFA scores and the remaining biomarkers using the ALIR data. Threshold effect analysis using segmented regression evaluated correlations between markers and SOFA scores. Results The values of Ang-2, ST-2, fractalkine, IL-1ra, TNFR1, PCT, and PTX-3, but not of C-peptide, were significantly higher in the severe sepsis than in the mild sepsis group. One-way logistic regression analysis indicated that the serum levels of Ang-2, ST-2, fractalkine, IL-1ra, TNFR1, PCT, and PTX-3, but not of C-peptide, significantly correlated with SOFA scores. Threshold effect analysis indicated significant nonlinear correlations between Ang-2, ST-2, IL-1ra, TNFR1, PCT, and PTX-3 levels and SOFA scores. Conclusions Although correlations between some plasma biomarkers and SOFA scores were nonlinear, these markers may be used as reference indexes to determine inflammation severity in sepsis.