The Role of Plasminogen Activator Inhibitor 1 in Predicting Sepsis-Associated Liver Dysfunction: An Observational Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design and Settings
2.2. Ethics
2.3. Participants
2.4. Outcomes
2.5. Analysed Biomarkers
2.5.1. IP-10
2.5.2. ET-1
2.5.3. Hepcidin
2.5.4. TAT
2.5.5. PAI-1
2.6. Statistical Analysis
3. Results
3.1. Comorbidities and Source of Sepsis
3.1.1. Comorbidities
3.1.2. Source of Sepsis
3.2. Routinely Measured Biomarkers
3.3. Analysed Biomarkers
3.4. PAI-1
3.4.1. PAI-1 Levels
3.4.2. PAI-1 as a Predictor of SALD
3.4.3. PAI-1 as a Predictor of Mortality
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All Patients (n = 79) | no-SALD (n = 55) | SALD (n = 24) | p | |
---|---|---|---|---|
Age (years) | 0.63 * | |||
Me (Q1–Q3) | 66 (57–76) | 67 (60–74) | 61 (46–78) | |
Min–Max | 19–88 | 23–88 | 19–88 | |
Sex | 0.83 ** | |||
(male/female) | 31/48 | 22(40%)/33(60%) | 9(38%)/15(62%) | |
SOFA (pts.) | 0.09 * | |||
Me (Q1–Q3) | 10 (7–13) | 9 (7–13) | 12(9–14) | |
Min–Max | 3–17 | 3–17 | 3–15 | |
APACHE II (pts.) | 0.98 | |||
Me (Q1–Q3) | 24 (15–30) | 24 (15–30) | 24 (15–28) | |
Min–Max | 15–30 | 8–44 | 7–37 | |
Sepsis/Septic shock | 32/47 | 25 (78%)/30 (64%) | 7 (22%)/17 (36%) | 0.18 ** |
28 day survival | 49 (62 ± 5.5%) | 37 (67.3 ± 6.3%) | 12 (50.0 ± 10.2%) | 0.12 *** |
Comorbidities | ||||
---|---|---|---|---|
All Patients (n = 79) | no-SALD (n = 55) | SALD (n = 24) | p | |
HTA | 37 (46.84%) | 26 (47.27%) | 11 (45.83%) | 0.89 |
DM | 23 (29.11%) | 19 (34.55%) | 4 (16.67%) | 0.18 |
CCD | 3 (3.8%) | 1 (1.82%) | 2 (8.33%) | 0.22 |
CA | 8 (10.13%) | 6 (10.91%) | 2 (8.33%) | 0.99 |
OBS | 8 (10.13%) | 5 (9.09%) | 3 (12.5%) | 0.69 |
CKD | 18 (23.68%) | 15 (27.27%) | 3 (12.5%) | 0.15 |
CPD | 10 (12.66%) | 8 (14.55%) | 2 (8.33%) | 0.72 |
ARY | 16 (20.25%) | 11 (22%) | 5 (20.83%) | 0.99 |
ALC | 10 (12.66%) | 7 (12.73%) | 3 (12.5%) | 0.99 |
NEUR | 4 (5.06%) | 4 (7.27%) | 0 | 0.31 |
OTH | 8 (10.13%) | 5 (9.09%) | 3 (12.5%) | 0.69 |
Source of Sepsis | ||||
---|---|---|---|---|
All Patients (n = 79) | No-SALD (n = 55) | SALD (n = 24) | p | |
Abdominal infection (ABD) | 32 (40.51%) | 23 (41.82%) | 9 (37.5%) | 0.91 |
Pulmonary infection (PNEU) | 27 (34.18%) | 17 (30.91%) | 10 (41.67%) | 0.50 |
Soft tissue infection (TISS) | 3 (3.8%) | 2 (3.64%) | 1 (4.17%) | 0.99 |
Neuroinfection (NEUR) | 4 (5.06%) | 3 (5.45%) | 1 (4.17%) | 0.99 |
Bloodstream infection (BSI) | 3 (3.8%) | 0 | 3 (12.5%) | 0.026 |
Urinary tract infection (UTI) | 6 (7.59%) | 6 (10.91%) | 0 | 0.17 |
UTI. PNEU | 1 (1.27%) | 1 (1.82%) | 0 | 0.99 |
NEUR. BSI | 1 (1.27%) | 1 (1.82%) | 0 | 0.99 |
PNEU. BSI | 2 (2.53%) | 2 (3.64%) | 0 | 0.99 |
Normal Plasma Values | no-SALD (n = 55) | SALD (n = 24) | p | |
---|---|---|---|---|
Me (Q1–Q3) | Me (Q1–Q3) | |||
AST (U/L) | 5–34 | 51 (29–155) | 124 (38–325) | 0.020 |
ALT (U/L) | 0–55 | 46 (20–81) | 61.5 (27–102) | 0.16 |
Albumin (g/dL) | 3.2–4.6 | 2.35 (2.0–2.65) | 2.3 (1.8–2.7) | 0.85 |
AT III (%) | 80–120 | 58.5 (45–81.1) | 53.3 (41.3–61.3) | 0.08 |
INR | 0.9–1.3 | 1.26 (1.12–1.45) | 1.35 (1.16–1.83) | 0.13 |
Prothrombin ratio (%) | 80–114 | 79.7 (66.6–87.8) | 73.7 (55.8–86.3) | 0.27 |
APTT (s) | 21–30.1 | 36.9 (30.9–46.7) | 44.3 (33.9–53.6) | 0.09 |
ALP (U/L) | <270 | 75 (54–148) | 147.5 (94–206) | 0.003 |
Lactate (mmol/L) | <2 | 2 (1.3–3.6) | 4.75 (1.6–8.95) | 0.041 |
PCT (ng/mL) | <0.05 | 4 (1.7–17.8) | 28 (3.1–71.3) | 0.0144 |
BIL (mg/dL) | 0.3–1.2 | 0.70 (0.50–1.30) | 2.25 (1.10–4.16) | <0.001 |
CRP (mg/L) | <5 | 239.8 (141.8–322.9) | 247.2 (155–318) | 0.44 |
Normal Plasma Values | All Patients (n = 79) | no-SALD (n = 55) | SALD (n = 24) | p | |
---|---|---|---|---|---|
IP-10 (pg/mL) | 47–382 | 932.7 ± 1643.5 | 321.9 (198.7–796.9) | 315.4 (140.7–961.1) | 0.99 |
ET-1 (pg/mL) | 0.58–1.96 | 2.06 ± 1.60 | 1.72 (1.19–2.45) | 1.54 (1.06–2.39) | 0.79 |
PAI-1 (ng/mL) | 0.99–16.9 | 38.3 ± 53.3 | 13.1 (6.5–29.9) | 51.6 (9.9–74.9) | 0.020 |
TAT (ng/mL) | 0.5–10 | 21.3 ± 116.6 | 4.3 (2.6–6.5) | 3.75 (2.83–5.75) | 0.81 |
Hepcidin (ng/mL) | 82.4–56700 | 221.8 ± 167.1 | 195 (101.1–321.9) | 158.2 (93.5–217.9) | 0.35 |
Variables | Univariate | |||
---|---|---|---|---|
HR | 95% CI | p | ||
Age | 1.04 | 1.01 | 1.07 | 0.011 |
SOFA | 1.14 | 1.03 | 1.27 | 0.009 |
APACHE II | 1.06 | 1.02 | 1.10 | 0.003 |
Lactate (mmol/L) | 1.14 | 1.06 | 1.22 | <0.001 |
CRP (mg/L) | 1.00 | 1.00 | 1.00 | 0.53 |
PCT (ng/mL) | 1.00 | 1.00 | 1.00 | 0.98 |
BIL (mg/dL) | 1.12 | 0.94 | 1.35 | 0.21 |
AST (U/L) | 1.00 | 1.00 | 1.00 | 0.82 |
ALP (U/L) | 1.00 | 1.00 | 1.00 | 0.96 |
PAI-1 (ng/mL) | 1.01 | 1.00 | 1.01 | 0.007 |
Sex (ref. M) | 1.78 | 0.87 | 3.65 | 0.11 |
SALD (ref. no) | 1.80 | 0.87 | 3.75 | 0.12 |
PAI-1 (ref. ≤ 48.73) | 2.97 | 1.42 | 6.19 | 0.004 |
Multivariate | ||||
Age | 1.04 | 1.02 | 1.07 | 1.002 |
Lactate (mmol/L) | 1.18 | 1.09 | 1.29 | <0.001 |
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Woźnica-Niesobska, E.; Leśnik, P.; Janc, J.; Zalewska, M.; Łysenko, L. The Role of Plasminogen Activator Inhibitor 1 in Predicting Sepsis-Associated Liver Dysfunction: An Observational Study. Int. J. Environ. Res. Public Health 2023, 20, 4846. https://doi.org/10.3390/ijerph20064846
Woźnica-Niesobska E, Leśnik P, Janc J, Zalewska M, Łysenko L. The Role of Plasminogen Activator Inhibitor 1 in Predicting Sepsis-Associated Liver Dysfunction: An Observational Study. International Journal of Environmental Research and Public Health. 2023; 20(6):4846. https://doi.org/10.3390/ijerph20064846
Chicago/Turabian StyleWoźnica-Niesobska, Ewa, Patrycja Leśnik, Jarosław Janc, Małgorzata Zalewska, and Lidia Łysenko. 2023. "The Role of Plasminogen Activator Inhibitor 1 in Predicting Sepsis-Associated Liver Dysfunction: An Observational Study" International Journal of Environmental Research and Public Health 20, no. 6: 4846. https://doi.org/10.3390/ijerph20064846