Endothelial cell-specific molecule–1/endocan: Diagnostic and prognostic value in patients suffering from severe sepsis and septic shock

• Published in: Journal of critical care 2016-02, Vol.31 (1), p.68-75
• Main Authors: Pauly, Dominic, MS, Hamed, Sonja, MS, Behnes, Michael, MD, Lepiorz, Dominic, MS, Lang, Siegfried, PhD, Akin, Ibrahim, MD, Borggrefe, Martin, MD, Bertsch, Thomas, MD, Hoffmann, Ursula, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biomarkers; Biomarkers - blood; Calcitonin - blood; Calcitonin Gene-Related Peptide; Critical Care; Diagnosis; Endocan; Failure; Family physicians; Female; Heart attacks; Humans; Infections; Intensive care; Intensive care unit; Interleukin-6 - blood; Laboratories; Male; Medicine; Middle Aged; Mortality; Neoplasm Proteins - blood; Patients; Physiology; Predictive Value of Tests; Prognosis; Protein Precursors - blood; Proteoglycans - blood; Regression Analysis; Sepsis; Sepsis - blood; Sepsis - mortality; Septic shock; Severe sepsis; Shock, Septic - blood; Shock, Septic - diagnosis; Shock, Septic - mortality; Systemic Inflammatory Response Syndrome - blood
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2015.09.019

Abstract Purpose This study aims to assess the diagnostic and prognostic value of endocan in patients with severe sepsis or septic shock on a medical intensive care unit (ICU). Methods 150 patients suspected for at least severe sepsis were enrolled on a medical ICU. On days 1, 3, and 8, plasma levels of endocan, procalcitonin (PCT), and interleukin (IL)-6 were measured. Follow-up on all-cause mortality was performed after 30 days and 6 months. Results Endocan correlated with Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and Simplified Acute Physiology Score II (SAPS II) ( P < .006). Endocan was higher in patients with at least severe sepsis compared with systemic inflammatory response syndrome (SIRS) or sepsis patients ( P = .0006) on days 1, 3, and 8. With a minimum sensitivity of 70%, uniform cutoff levels were set for ≥ sepsis at 1.8 ng/mL, for ≥ severe sepsis at 2.6 ng/mL, for ≥ septic shock at 2.9 ng/mL. On day 1, endocan levels of the fourth quartile were significantly associated with 30-days and 6-months mortality compared to lower levels. After adjustment in Cox regressions, endocan still revealed prognostic value. Conclusions Endocan showed diagnostic capacity to diagnose patients with severe sepsis and septic shock and revealed prognostic information for 30-days and 6-months all-cause mortality.