Open Access

Risk stratification and prognostic evaluation of endothelial cell‑specific molecule1, von Willebrand factor, and a disintegrin‑like and metalloprotease with thrombospondin type 1 motif for sepsis in the emergency department: An observational study

  • Authors:
    • Qing Zhang
    • Chun‑Sheng Li
  • View Affiliations

  • Published online on: April 15, 2019     https://doi.org/10.3892/etm.2019.7485
  • Pages: 4527-4535
  • Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

This study evaluated endothelial cell‑specific molecule1 (endocan), von Willebrand factor (vWF), and A disintegrin‑like and metalloprotease with thrombospondin type 1 motif (ADAMTS‑13), alone or in combination, in the risk stratification and prognosis prediction of patients with sepsis. Clinical data of 301 patients were prospectively analyzed, and divided into systemic inflammatory reaction syndrome, sepsis, severe sepsis, and septic shock groups. A total of 40 healthy individuals were studied as the control group. Endocan, vWF, ADAMTS‑13, vWF/ADAMTS‑13, and procalcitonin levels were measured, and Acute Physiology and Chronic Health Evaluation (APACHE II) score, Mortality in Emergency Department Sepsis (MEDS) score as well as Sequential Organ Failure Assessment (SOFA) score were calculated. The all‑cause death or survival of each patient was recorded during the 28-day follow‑up. The endocan, vWF, and vWF/ADAMTS‑13 levels significantly increased in patients and were positively correlated with disease severity. On the first day of admission, MEDS score, ADAMTS‑13, and vWF/AMAMTS‑13 ratio were independent predictors for 28-day mortality from sepsis. Moreover, the combination of vWF/ADAMTS‑13 ratio with MEDS score improved the accuracy in predicting the 28-day mortality from sepsis. On day 5, endocan, vWF, ADAMTS‑13, and vWF/ADAMTS‑13 ratio were independent predictors for the 28-day mortality from sepsis, while the combined use of endocan and vWF/ADAMTS‑13 ratio improved the prognostic value of individual indicators. Endocan, vWF, ADAMTS‑13, and vWF/ADAMTS‑13 ratio are valuable in the risk stratification and prognostic evaluation of sepsis as novel biomarkers.

References

1 

Lever A and Mackenzie I: Sepsis: Definition, epidemiology, and diagnosis. BMJ. 335:879–883. 2007. View Article : Google Scholar : PubMed/NCBI

2 

Zambon M, Ceola M, Almeida-de-Castro R, Gullo A and Vincent JL: Implementation of the surviving sepsis campaign guidelines for severe sepsis and septic shock: We could go faster. J Crit Care. 23:455–460. 2008. View Article : Google Scholar : PubMed/NCBI

3 

Pierrakos C and Vincent JL: Sepsis biomarkers: A review. Crit Care. 14:R152010. View Article : Google Scholar : PubMed/NCBI

4 

Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, Cohen J, Opal SM, Vincent JL and Ramsay G; SCCM/ESICM/ACCP/ATS/SIS, : 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med. 31:1250–1256. 2003. View Article : Google Scholar : PubMed/NCBI

5 

Knaus WA, Draper EA, Wagner DP and Zimmerman JE: APACHE II: A severity of disease classification system. Crit Care Med. 13:818–829. 1985. View Article : Google Scholar : PubMed/NCBI

6 

Shapiro NI, Wolfe RE, Moore RB, Smith E, Burdick E and Bates DW: Mortality in Emergency Department Sepsis (MEDS) score: a prospectively derived and validated clinical prediction rule. Crit Care Med. 31:670–675. 2003. View Article : Google Scholar : PubMed/NCBI

7 

Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, Reinhart CK, Suter PM and Thijs LG: The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the working group on sepsis-related problems of the European Society of Intensive Care Medicine. Intensive Care Med. 22:707–710. 1996. View Article : Google Scholar : PubMed/NCBI

8 

Shirakawa K, Naitou K, Hirose J, Takahashi T and Furusako S: Presepsin (sCD14-ST): Development and evaluation of one-step ELISA with a new standard that is similar to the form of presepsin in septic patients. Clin Chem Lab Med. 49:937–939. 2011. View Article : Google Scholar : PubMed/NCBI

9 

Alberti C, Brun-Buisson C, Burchardi H, Martin C, Goodman S, Artigas A, Sicignano A, Palazzo M, Moreno R, Boulmé R, et al: Epidemiology of sepsis and infection in ICU patients from an international multicentre cohort study. Intensive Care Med. 28:108–121. 2002. View Article : Google Scholar : PubMed/NCBI

10 

Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, Moreno R, Carlet J, Le Gall JR and Payen D; Sepsis occurrence in acutely Ill patients investigators, : Sepsis in European intensive care units: Results of the SOAP study. Crit Care Med. 34:344–353. 2006. View Article : Google Scholar : PubMed/NCBI

11 

Esteban A, Frutos-Vivar F, Ferguson ND, Peñuelas O, Lorente JA, Gordo F, Honrubia T, Algora A, Bustos A, García G, et al: Sepsis incidence and outcome: Contrasting the intensive care unit with the hospital ward. Crit Care Med. 35:1284–1289. 2007. View Article : Google Scholar : PubMed/NCBI

12 

Gonsalves MD and Sakr Y: Early identification of sepsis. Curr Infect Dis Rep. 12:329–335. 2010. View Article : Google Scholar : PubMed/NCBI

13 

Bauer M and Reinhart K: Molecular diagnostics of sepsis - where are we today? Int J Med Microbiol. 300:411–413. 2010. View Article : Google Scholar : PubMed/NCBI

14 

Levy MM: Preface biomarkers in critical illness. Crit Care Clin. 27:xiii–xv. 2011. View Article : Google Scholar : PubMed/NCBI

15 

Bongers TN, de Maat MP, van Goor ML, Bhagwanbali V, van Vliet HH, Gómez García EB, Dippel DW and Leebeek FW: High von Willebrand factor levels increase the risk of first ischemic stroke: Influence of ADAMTS13, inflammation, and genetic variability. Stroke. 37:2672–2677. 2006. View Article : Google Scholar : PubMed/NCBI

16 

Nguyen TC, Liu A, Liu L, Ball C, Choi H, May WS, Aboulfatova K, Bergeron AL and Dong JF: Acquired ADAMTS-13 deficiency in pediatric patients with severe sepsis. Haematologica. 92:121–124. 2007. View Article : Google Scholar : PubMed/NCBI

17 

Claus RA, Bockmeyer CL, Budde U, Kentouche K, Sossdorf M, Hilberg T, Schneppenheim R, Reinhart K, Bauer M, Brunkhorst FM, et al: Variations in the ratio between von Willebrand factor and its cleaving protease during systemic inflammation and association with severity and prognosis of organ failure. Thromb Haemost. 101:239–247. 2009. View Article : Google Scholar : PubMed/NCBI

18 

Scherpereel A, Depontieu F, Grigoriu B, Cavestri B, Tsicopoulos A, Gentina T, Jourdain M, Pugin J, Tonnel AB and Lassalle P: Endocan, a new endothelial marker in human sepsis. Crit Care Med. 34:532–537. 2006. View Article : Google Scholar : PubMed/NCBI

19 

Chng WJ, Yip CY, Baliwag MB and Liu TC: Differential effect of the ABO blood group on von Willebrand factor collagen binding activity and ristocetin cofactor assay. Blood Coagul Fibrinolysis. 16:75–78. 2005. View Article : Google Scholar : PubMed/NCBI

20 

Sadler JE: Biochemistry and genetics of von Willebrand factor. Annu Rev Biochem. 67:395–424. 1998. View Article : Google Scholar : PubMed/NCBI

21 

van Mourik JA, Boertjes R, Huisveld IA, Fijnvandraat K, Pajkrt D, van Genderen PJ and Fijnheer R: von Willebrand factor propeptide in vascular disorders: a tool to distinguish between acute and chronic endothelial cell perturbation. Blood. 94:179–185. 1999.PubMed/NCBI

22 

Lerolle N, Dunois-Lardé C, Badirou I, Motto DG, Hill G, Bruneval P, Diehl JL, Denis CV and Baruch D: von Willebrand factor is a major determinant of ADAMTS-13 decrease during mouse sepsis induced by cecum ligation and puncture. J Thromb Haemost. 7:843–850. 2009. View Article : Google Scholar : PubMed/NCBI

23 

Dong JF, Moake JL, Nolasco L, Bernardo A, Arceneaux W, Shrimpton CN, Schade AJ, McIntire LV, Fujikawa K and López JA: ADAMTS-13 rapidly cleaves newly secreted ultralarge von Willebrand factor multimers on the endothelial surface under flowing conditions. Blood. 100:4033–4039. 2002. View Article : Google Scholar : PubMed/NCBI

24 

Ley K, Laudanna C, Cybulsky MI and Nourshargh S: Getting to the site of inflammation: The leukocyte adhesion cascade updated. Nat Rev Immunol. 7:678–689. 2007. View Article : Google Scholar : PubMed/NCBI

25 

Reiter RA, Varadi K, Turecek PL, Jilma B and Knöbl P: Changes in ADAMTS13 (von-Willebrand-factor-cleaving protease) activity after induced release of von Willebrand factor during acute systemic inflammation. Thromb Haemost. 93:554–558. 2005. View Article : Google Scholar : PubMed/NCBI

26 

Martin K, Borgel D, Lerolle N, Feys HB, Trinquart L, Vanhoorelbeke K, Deckmyn H, Legendre P, Diehl JL and Baruch D: Decreased ADAMTS-13 (A disintegrin-like and metalloprotease with thrombospondin type 1 repeats) is associated with a poor prognosis in sepsis-induced organ failure. Crit Care Med. 35:2375–2382. 2007. View Article : Google Scholar : PubMed/NCBI

27 

Cao WJ, Niiya M, Zheng XW, Shang DZ and Zheng XL: Inflammatory cytokines inhibit ADAMTS13 synthesis in hepatic stellate cells and endothelial cells. J Thromb Haemost. 6:1233–1235. 2008. View Article : Google Scholar : PubMed/NCBI

28 

Ono T, Mimuro J, Madoiwa S, Soejima K, Kashiwakura Y, Ishiwata A, Takano K, Ohmori T and Sakata Y: Severe secondary deficiency of von Willebrand factor-cleaving protease (ADAMTS13) in patients with sepsis-induced disseminated intravascular coagulation: Its correlation with development of renal failure. Blood. 107:528–534. 2006. View Article : Google Scholar : PubMed/NCBI

29 

Biron BM, Ayala A and Lomas-Neira JL: Biomarkers for sepsis: What is and what might be? Biomark Insights. 10 (Suppl 4):7–17. 2015.PubMed/NCBI

30 

Pepys MB and Hirschfield GM: C-reactive protein: A critical update. J Clin Invest. 111:1805–1812. 2003. View Article : Google Scholar : PubMed/NCBI

31 

Maruna P, Nedelníková K and Gürlich R: Physiology and genetics of procalcitonin. Physiol Res. 49 (Suppl 1):S57–S61. 2000.PubMed/NCBI

32 

Becker KL, Snider R and Nylen ES: Procalcitonin assay in systemic inflammation, infection, and sepsis: Clinical utility and limitations. Crit Care Med. 36:941–952. 2008. View Article : Google Scholar : PubMed/NCBI

33 

Billeter A, Turina M, Seifert B, Mica L, Stocker R and Keel M: Early serum procalcitonin, interleukin-6, and 24-hour lactate clearance: useful indicators of septic infections in severely traumatized patients. World J Surg. 33:558–566. 2009. View Article : Google Scholar : PubMed/NCBI

34 

Brunkhorst FM, Al-Nawas B, Krummenauer F, Forycki ZF and Shah PM: Procalcitonin, C-reactive protein and APACHE II score for risk evaluation in patients with severe pneumonia. Clin Microbiol Infect. 8:93–100. 2002. View Article : Google Scholar : PubMed/NCBI

35 

Bele N, Darmon M, Coquet I, Feugeas JP, Legriel S, Adaoui N, Schlemmer B and Azoulay E: Diagnostic accuracy of procalcitonin in critically ill immunocompromised patients. BMC Infect Dis. 11:2242011. View Article : Google Scholar : PubMed/NCBI

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June 2019
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Copy and paste a formatted citation
APA
Zhang, Q., & Zhang, Q. (2019). Risk stratification and prognostic evaluation of endothelial cell‑specific molecule1, von Willebrand factor, and a disintegrin‑like and metalloprotease with thrombospondin type 1 motif for sepsis in the emergency department: An observational study. Experimental and Therapeutic Medicine, 17, 4527-4535. https://doi.org/10.3892/etm.2019.7485
MLA
Zhang, Q., Li, C."Risk stratification and prognostic evaluation of endothelial cell‑specific molecule1, von Willebrand factor, and a disintegrin‑like and metalloprotease with thrombospondin type 1 motif for sepsis in the emergency department: An observational study". Experimental and Therapeutic Medicine 17.6 (2019): 4527-4535.
Chicago
Zhang, Q., Li, C."Risk stratification and prognostic evaluation of endothelial cell‑specific molecule1, von Willebrand factor, and a disintegrin‑like and metalloprotease with thrombospondin type 1 motif for sepsis in the emergency department: An observational study". Experimental and Therapeutic Medicine 17, no. 6 (2019): 4527-4535. https://doi.org/10.3892/etm.2019.7485