Combined suPAR and qSOFA as A Mortality Predictor in ICU Patients with Sepsis.

Introduction: Prediction of 28 days mortality in ICU patients with sepsis enables physicians to pay special attention to concerned patients and may affect their management. Scoring systems are widely used in clinical practice as mortality predictors. But all have their limitation. Different biomarkers also lack enough sensitivity and specificity. We studied the concentrations of suPAR, measured in serum on the first day of suspected sepsis, comparing combined suPAR and qSOFA with suPAR, qSOFA and SOFA (alone) as a predictor of 28 days mortality in ICU patients. Method: This study was conducted in ICU at Zagazig University Hospitals. 131 sepsis patients were included and classified according to 28 days mortality into: survivors (113/86.3%) and non-survivors (18/13.7%). Serum sample for suPAR measurement, and parameters of SOFA were collected upon suspicion of sepsis. Then, SOFA and qSOFA were calculated. Results: The best predictor of 28 days mortality was SOFA at cutoff 9 (AUC) followed by suPAR at cutoff 12.32 ng/ml (AUC 0.918 and 0.770) and (95% CI 0.849-0.988 and 0.634-0.906) respectively with no statistical difference between them. Combining suPAR and SOFA and combining suPAR and qSOFA increased AUC to 0.941 and 0.827 (95% CI 0.892-0.990 and 0.729-0.926) respectively. There was no statistical difference between AUC of combined suPAR and qSOFA and AUC of standard SOFA score. Conclusion: In our model, suPAR had 28 days mortality prognostic ability comparable to SOFA and better than qSOFA. Combining suPAR and qSOFA increased the prognostic ability of qSOFA to be not inferior to that of SOFA. [ABSTRACT FROM AUTHOR]