Key result
Elevated neopterin (≥40 nmol/L) and E-alpha 1 PI (≥/L) predicted a Multiple Organ Failure score ≥5 one day prior with 91% sensitivity and 99% specificity.
Why the study?
Do neopterin and E-alpha 1 PI plasma levels correlate with the severity of multiple organ failure and diagnosis of septicemia in postoperative and septic patients?
Observational (n=56)
Do neopterin and E-alpha 1 PI plasma levels correlate with the severity of multiple organ failure and diagnosis of septicemia in postoperative and septic patients?
Answers are grounded in this paper and cite their sources.
Neopterin and E-alpha 1 PI plasma levels are useful biomarkers for diagnosing septicemia and monitoring the clinical course of multiple organ failure in septic patients.
In a series of 56 patients (24 uncomplicated postoperative and 32 septic patients), neopterin and elastase alpha 1 protease inhibitor complex (E-alpha 1 PI) plasma levels were measured daily. The clinical course of each patient was evaluated with the Multiple Organ Failure (MOF) score according to Goris. Neopterin could differentiate between septic and nonseptic patients (p less than .001), and E-alpha 1 PI between septic nonsurvivors and nonseptic patients only (p less than .01). In septic patients, acute pulmonary insufficiency was indicated by elevated E-alpha 1 PI values (greater than or equal to 400 micrograms/L) 1 day before mechanical ventilation was performed with a sensitivity of 81% and a specificity of 82%. Defining a patient with MOF whose score was greater than or equal to 5 as a high-risk septic patient, a comparison neopterin greater than or equal to 40 nmol/L and E-alpha 1 PI greater than or equal to 400 micrograms/L, measured 1 day before the evaluation of an MOF score of greater than or equal to 5 yielded a sensitivity of 91% and a specificity of 99% when patients fulfilled both criteria. We conclude that neopterin and E-alpha 1 PI might be useful parameters for the diagnosis of septicemia and monitoring of the clinical course in septic patients. Moreover, they might indicate the possible central role of macrophage and PMN activation in the development of MOF.
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Pacher et al. (1989) conducted an observational in Multiple organ failure and sepsis (n=56). Neopterin and E-alpha 1 PI plasma levels vs. Nonseptic patients or lower biomarker levels was evaluated on Differentiation between septic and nonseptic patients using neopterin (p=<0.001). Elevated neopterin (≥40 nmol/L) and E-alpha 1 PI (≥/L) predicted a Multiple Organ Failure score ≥5 one day prior with 91% sensitivity and 99% specificity.
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