Key result
Platelet activation perfectly predicts sepsis with a 1.0 AUC, while dynamic biomarker changes predict survival.
Why the study?
Early diagnosis and accurate prognosis are key for reducing fatality and medical expenses in sepsis, but the usefulness of platelet-related parameters as prognostic markers remains to be clarified.
Do platelet-related parameters correlate with disease severity and prognosis in patients with sepsis?
Observational (n=56)
No
Do platelet-related parameters correlate with disease severity and prognosis in patients with sepsis?
Effect estimate: AUC 1.0
p-value: p=<0.0001
Dynamic monitoring of platelet phosphatidylserine exposure, Mmp-Index, and plasma Ang-2 levels may serve as prognostic biomarkers for disease severity and clinical outcomes in sepsis.
May support platelet markers for sepsis prognosis; leaves open prospective validation before clinical use.
Early diagnosis and accurate prognosis are key for reducing the fatality rate and medical expenses associated with sepsis. Platelets are involved in the delayed tissue injury that occurs during sepsis. Therefore, the aim of the present study was to investigate the usefulness of platelets and associated parameters as prognostic markers of sepsis. The present study collected patient samples based on The Third International Consensus Definitions for Sepsis and Septic Shock criteria. Platelet-associated parameters were detected by flow cytometry and their correlation with clinical scores and prognoses was analyzed. Considering the association between endothelial cells and platelet activation, levels of plasma tumor necrosis factor-like weak inducer of apoptosis (TWEAK) and angiopoietin-2 (Ang-2) were analyzed by ELISA. The results showed significant differences in platelet P-selectin expression and phosphatidylserine exposure, mitochondrial membrane potential (Mmp)-Index values and plasma levels of TWEAK and Ang-2 between patients and healthy controls (P<0.05). Except for P-selectin and TWEAK levels, all parameters were correlated with clinical scores (acute physiology and chronic health evaluation II and sequential/sepsis-related organ failure assessment). Additionally, platelet Mmp-Index between admission and the end of therapy was only different in non-survivors (P<0.001) and platelet phosphatidylserine exposure was significantly lower in survivors (P=0.006). Therefore, of the parameters tested, the dynamic monitoring of phosphatidylserine exposure, platelet Mmp-Index values and plasma Ang-2 levels had the most potential for the assessment of disease severity and clinical outcomes.
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Zhang et al. (2023) conducted an observational in Sepsis and septic shock (n=56). Platelet-related parameters (platelet activation, Mmp-Index, apoptosis, TWEAK, Ang-2) vs. Healthy controls / Survivors was evaluated on Prediction of sepsis and septic shock using platelet activation level (AUC 1.0, p=<0.0001). Platelet activation level perfectly predicted sepsis and septic shock with an AUC of 1.0, while dynamic changes in phosphatidylserine exposure, Mmp-Index, and Ang-2 levels significantly differentiated survivors from non-survivors.
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