Heparin binding protein as a reliable prognostic biomarker for severity of sepsis in the intensive care unit

ABSTRACT

Background

It is still challenging to identify people who are at risk for developing sepsis quickly and early. Heparin-binding protein (HBP) has been demonstrated a promising data that can be used as predictive qualities in identifying organ failure.

Methods

This prospective observational investigation of 55 adult patients who have been proven to have sepsis, and were hospitalized into the intensive care unit. By carrying out HBP, procalcitonin (PROCAL), C-reactive protein (CRP), serum lactate, SOFA score on admission and after 72 hours and detecting 28-day mortality.

Results

Despite PROCAL and HBP were higher in survival than non-survival patients at day 0 (1010.32 ± 341.72 vs 770.21 ± 327.97, p = 0.0112) (16.73 ± 7.19 vs 13.19 ± 7.26, p = 0.077) respectively, It was significantly lower in survival than non-survival at day 3 (542.09 ± 191.98 vs 995.00 ± 333.74, p =<0.0001) (9.03 ± 2.92 vs 16.67 ± 7.55,p =<0.0001) respectively. Our main marker HBP decreased significantly from day 0 to day 3 for survival patients with paired difference −7.69 ± 6.78 with p value < 0.0001, while it is increased with non-significant value for non-survival patients with paired difference 3.48 ± 9.45 with p value 0.084. ROC analysis for mortality showed for HBP that AUC at day 0 was 0.323 (p=0.025). At cut-off value of>15.5ng/ml, sensitivity was 29.2%, specificity was 64.5%, while at day 3 was 0.831 (p=0.000). At cut-off value of>9.5ng/ml, sensitivity was 83.33%, specificity was 77.42%.

Conclusion

HPB showed a strong prognostic marker of mortality in ICU septic patients at day 3 more than day 0 with important value and trend.

KEYWORDS:

• Heparin-binding protein
• prognostic
• biomarker
• sepsis
• ICU
• mortality

Disclosure statement

The authors report no financial or non-financial conflicts of interest in this work.

Ethics approval and informed consent

Approval was obtained by the Institutional Review Board with code number: FMASU MD 159/2021, Board Name: research ethical committee, Board Affiliation: faculty of medicine Ain Shams university, and registered at ClinicalTrials.gov (ID;NCT05610020).

Previous presentation in conferences

Paper has not previously presented in conference.

Additional information

Funding

This research did not receive any specific grant. It is self-funded.