Relation of Procollagen Type III Amino Terminal Propeptide Level to Sepsis Severity in Pediatrics
Abstract
:1. Introduction
2. Subjects and Methods
2.1. Design
2.2. Methods
Ethical Approval
2.3. Statistical Analysis
3. Results
3.1. Demographic and Clinical Characteristics of the Studied Groups
3.2. Studied Patients Regarding Severity and Outcome of the Disease
3.3. Outcome of the Studied Groups
3.4. Association of Serum PIIINP with Disease Severity and Mortality
3.5. Correlations of PIIINP with Other Clinical and Laboratory Parameters
3.6. Area under the ROC Curve for PIIINP in Predicting Sepsis and Mortality
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Studied Variables | The Studied Groups | Test of Significance | p Value | |
---|---|---|---|---|
Patients (n = 170) | Control (n = 100) | |||
Age (month) | ||||
Mean ± SD | 26.53 ± 40.2 | 28.9 ± 44.7 | ||
Median (Range) | 26.8 (1.5–192) | 28.8 (2–180) | U = 0.2578 | 0.79 |
Sex No (%) | ||||
Male | 75 (44.2%) | 40 (40.0%) | ||
Female | 95 (55.8%) | 60 (60.0%) | Χ2 = 0.81 | 0.81 |
Weight (Kg) | ||||
Mean ± SD | 10.05 ± 7.7 | 11.7 ± 3.12 | ||
Median (Range) | 10.5 (2.1–45) | 11.5 (4.2–40) | U = 0.7618 | 0.44 |
Height (cm) | ||||
Mean ± SD | 78.19 ± 24.3 | 75.1 ± 20.9 | ||
Median (Range) | 88.12 (45–161) | 77.2 (55–130) | U = 0.5837 | 0.56 |
BMI (kg/m2) | ||||
Mean ± SD | 14.7 ± 2.8 | 14.8 ± 2.1 | ||
Median (Range) | 14.9 (8.2–21.6) | 15.6 (8.7–22.1) | U = 0.1670 | 0.86 |
MV No (%) | ||||
Yes | 27 (15.9%) | - | - | - |
No | 143 (84.1%) | |||
MV (h) | ||||
Mean ± SD | 276.6 ± 298.2 | - | - | - |
Range | 55–1028 | |||
PICU stay/day | ||||
Mean ± SD | 7.85 ± 9.2 | |||
Range | 1–16 | - | - | - |
Hospital stay/day | ||||
Mean ± SD | 10.36 ± 9.7 | |||
Median (Range) | 10.50 (2–35) | - | - | - |
PRISM score | ||||
Mean ± SD | 22.1 ± 15.2 | |||
Median (Range) | 27.5 (0–46) | - | - | - |
PRISM mortality risk % | ||||
Mean ± SD | 25.63 ± 28.9 | |||
Median (Range) | 25.72 (8–64.4) | - | - | - |
PIM mortality risk % | ||||
Mean ± SD | 6.85 ± 12.4 | |||
Median (Range) | 6.96 (2–66) | - | - | - |
Mortality No (%) | ||||
Yes | 19 (11.2%) | |||
No | 151 (88.8%) | - | - | - |
Sepsis (n = 90) | Severe Sepsis (n = 53) | Septic Shock (n = 27) | p Value | |
---|---|---|---|---|
Age (Months) | ||||
Median (Range) | 58.9 (25.2 ± 121.2) | 20.4 (2.4 ± 43.2) | 81.6 (55.2 ± 175.2) | 0.076 |
Sex No | ||||
Male | 35 | 28 | 12 | 0.934 |
Female | 55 | 25 | 15 | |
Disease severity | ||||
MV (n = 27) | 3 | 5 | 19 | <0.001 ** |
Use of vasopressor | 0 | 0 | 27 | <0.001 ** |
PRISM Median (Range) | 9 (6 ± 10) | 15 (9 ± 17) | 25 (19 ± 46) | <0.001 ** |
P-MODS | 0 (0 ± 1) | 1 (0 ± 3) | 6 (3 ± 9) | <0.001 ** |
DIC score | 2 (0 ± 2) | 3 (1 ± 3) | 5 (3 ± 5) | <0.001 ** |
Outcome | ||||
Mortality (n = 19) | 1 | 2 | 16 | 0.018 * |
PICU stay (days) | ||||
Median (Range) | 5.6 (4 ± 10) | 9.5 (8 ± 17) | 9 (4 ± 16) | 0.137 |
Hospital stays | ||||
Median (Range) | 16 (9 ± 21) | 17 (14 ± 33) | 18 (12 ± 28) | 0.562 |
PIIINP (ng/mL) | The Studied Groups | Mann Whitney (U) Test | p Value | |
---|---|---|---|---|
Patients (n = 170) | Control (n = 100) | |||
PIIINP | ||||
Mean ± SD | 614.9 ± 432.9 | 3.6 ± 0.66 | 6.7826 | <0.001 ** |
Median (Range) | 615.9 (29.5–1370) | 3.9 (1.9–4.9) | ||
Sepsis (n = 90) | Control (n = 100) | |||
PIIINP | ||||
Mean ± SD | 149.24 ± 79.79 | 3.6 ± 0.66 | 6.8953 | <0.001 ** |
Median (Range) | 149.5 (29.6–272.9) | 3.9 (1.9–4.9) | ||
Severe sepsis (n = 53) | Control (n = 100) | |||
PIIINP | ||||
Mean ± SD | 568.26 ± 440.8 | 3.6 ± 0.66 | 5.391 | <0.001 ** |
Median (Range) | 568.3 (32.5–1304.7) | 3.9 (1.9–4.9) | ||
Septic shock (n = 27) | Control (n = 100) | |||
PIIINP | ||||
Mean ± SD | 926.16 ±246.7 | 3.6 ± 0.66 | 7.1568 | <0.001 ** |
Median (Range) | 926.2 (460.6–1370) | 3.9 (1.9–4.9) | ||
Sepsis (n = 90) | Severe sepsis (n = 53) | |||
PIIINP | ||||
Mean ± SD | 149.24 ± 79.79 | 568.26 ± 440.8 | 5.5085 | <0.001 ** |
Median (Range) | 149.5 (29.6–272.9) | 568.3 (32.5–1304.7) | ||
Sepsis (n = 90) | Septic shock (n = 27) | |||
PIIINP | ||||
Mean ± SD | 149.24 ± 79.79 | 926.16 ± 246.7 | 2.1472 | <0.001 ** |
Median (Range) | 149.3 (29.6–272.9) | 926.2 (460.6–1370) | ||
Severe sepsis (n = 53) | Septic shock (n = 27) | |||
PIIINP | ||||
Mean ± SD | 568.26 ± 440.8 | 926.16 ± 246.7 | 3.9023 | <0.001 ** |
Median (Range) | 568.3 (32.5–1304.7) | 926.2 (460.6–1370) | ||
Mechanically ventilated (n = 27) | Non-mechanically ventilated (n = 143) | |||
PIIINP | ||||
Mean ± SD | 908.2 ± 206.85 | 578.86 ± 431.57 | 2.228 | 0.029 * |
Median (Range) | 908.3(104.6–1370) | 578.9 (29.6–1304.1) | ||
Survivors (n = 151) | Non-Survivor (n = 19) | |||
PIIINP | ||||
Mean ± SD | 586.46 ± 433.7 | 935.32 ± 232.9 | 2.229 | 0.016 * |
Median (Range) | 586.5 (29.6–1169) | 935.4 (104.6–1370) |
Studied Variable | Serum PIIINP | |
---|---|---|
R | p Value | |
Age | 0.207 | 0.074 |
Hospital stay | 0.251 | 0.03 * |
PICU stay | 0.318 | <0.001 ** |
PRISM risk mortality % | 0.313 | 0.047 * |
PIM risk mortality % | 0.315 | 0.044 * |
WBCs | 0.26 | 0.024 * |
Platelets | 0.064 | 0.58 |
CRP | 0.327 | 0.004 * |
Total bilirubin | −0.045 | 0.703 |
Albumin | −0.105 | 0.37 |
Creatinine | 0.01 | 0.93 |
PT | 0.479 | 0.003 * |
Fibrinogen | −0.288 | 0.069 |
DIC score | 0.562 | <0.001 ** |
P-MODS | 0.551 | <0.001 ** |
PIIINP | CRP | WBCs | |
---|---|---|---|
AUC | 0.883 | 0.986 | 0.88 |
p value | <0.001 | <0.001 | <0.001 |
95% CI | 0.81–0.94 | 0.96.5−0.99 | 0.815–0.945 |
Cutoff point | 103.3 | 10.22 | 6.9 |
Sensitivity | 88% | 88% | 81% |
Specificity | 82% | 99.20% | 56% |
PPV | 83% | 90% | 66% |
NPV | 87% | 89% | 82% |
Accuracy | 88% | 90% | 67.50% |
PIIINP | CRP | PRISM Mortality Risk | PIM II Mortality Risk | |
---|---|---|---|---|
AUC | 0.651 | 0.749 | 0.93 | 0.96 |
p value | <0.001 | <0.001 | <0.001 | <0.001 |
95% CI | 0.47–0.83 | 0.62–0.87 | 085–0.99 | 0.915–0.99 |
Cutoff point | 490.4 | 41.4 | 4.25 | 6.8 |
Sensitivity | 87.50% | 99% | 87.50% | 99% |
Specificity | 51.60% | 52% | 78% | 89% |
PPV | 16.70% | 18.60% | 76.70% | 89% |
NPV | 97% | 99.70% | 87% | 99% |
Accuracy | 88% | 90% | 88% | 99% |
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Saleh, N.Y.; Aboelghar, H.M.; Salem, S.S.; Soliman, S.E.; Elian, D.M. Relation of Procollagen Type III Amino Terminal Propeptide Level to Sepsis Severity in Pediatrics. Children 2021, 8, 791. https://doi.org/10.3390/children8090791
Saleh NY, Aboelghar HM, Salem SS, Soliman SE, Elian DM. Relation of Procollagen Type III Amino Terminal Propeptide Level to Sepsis Severity in Pediatrics. Children. 2021; 8(9):791. https://doi.org/10.3390/children8090791
Chicago/Turabian StyleSaleh, Nagwan Y., Hesham M. Aboelghar, Sherif S. Salem, Shimaa E. Soliman, and Doaa M. Elian. 2021. "Relation of Procollagen Type III Amino Terminal Propeptide Level to Sepsis Severity in Pediatrics" Children 8, no. 9: 791. https://doi.org/10.3390/children8090791