Prognostic Significance of the angiopoietin-2 for Early Prediction of Septic Shock in Severe Sepsis Patients

Figures & data

Table 1. Characteristics of sepsis patients and controls at hospital admission.

Characteristics	Healthy controls (n = 95)	Patients at hospital admission (T0)			p ^† value
		Severe sepsis (n = 52)	Septic shock (n = 53)	p ^‡ value
Age (years)	40 [19–75]	69.5 [16–90]	66 [38–91]	NS	<0.0001
Gender (male/female)	44/51	27/25	30/23	NS	NS
Mean arterial pressure (mmHg)	NA	91.7 [50–123.3]	71.7 [49–118]		NA
Hematocrit (%)	138 [104–169]	31.3 [20–44.4]	33.1 [17.8–53.9]	NS	NS
White blood cells (g/l)	6.5 [3.6–12.5]	13.95 [4.5–61.1]	14.5 [0.4–64.3]	NS	NS
Platelets (g/l)	242 [150–385]	198 [25–547]	106 [2–516]	<0.0001	<0.0001
Total bilirubin (μmol/l)	9.2 [3.1–25.7]	16.3 [6.3–202.9]	29.2 [5–205.1]	0.02	<0.0001
Blood creatinine (μmol/l)	77 [52.2–146.99]	76.25 [41.6–772]	150.05 [53.9–692.1]	<0.0001	<0.0001
Albumin (g/l)	NA	28.5 [17.8–118.4]	27.9 [15–45.3]	NS	NA
Procalcitonin (ng/ml)	NA	9.35 [0.32–200]	51.5 [3.5–200]	<0.0001	NA
Lactate (mmol/l)	NA	1.36 [1–2]	5.55 [2–18]	<0.0001	NA
Glasgow coma scale	NA	2 [0–4]	1 [0–4]	NS	NA
SOFA score	NA	5 [1–10]	6 [1–15]	0.018	NA
APACHE II score	NA	16.5 [3–27]	15 [5–28]	NS	NA
Ang-1 (pg/ml)	91.6 [1.65–1405.9]	334.57 [32–6498.7]	165.9 [11.66–2459.5]	0.042	<0.0001
Ang-2 (pg/ml)	105.5 [21.9–337.2]	515.56 [76.2–1291.3]	1096.76 [44.2–1511.9]	<0.0001	<0.0001
Ang-1/Ang-2 ratio	0.8 [0.08–8.4]	0.53 [0.034–20.6]	0.14 [0.014–16.99]	0.001	<0.0001

† Comparison between patients and control individuals;

‡ Comparison between severe sepsis patients with septic shock patients.

Values given are medians and range.

APACHE II: Acute Physiology and Chronic Health Evaluation II; Ang: Angiopoietin; NA: Not applicable; NS: Not significant; SOFA: Sequential Organ Failure Assessment.

Figure 1. The levels of angiopoietin-1 and angiopoietin-2 in patients and control individuals.

(A) The levels of angiopoietin-1 (B) and angiopoietin-2 were measured in the serum samples from sepsis patients, those with septic shock at hospital admission, as well as in control individuals. (C) The ratios of angiopoietin-1 to angiopoietin-2 levels (Ang-1/Ang-2 ratio) were calculated for each patient and control individual and were compared between groups.

p values were calculated by using the Mann-Whitney U test.

Figure 2. The levels of angiopoietin-1 and angiopoietin-2 in patients at different time points.

(A) The levels of angiopoietin-1 (B) and angiopoietin-2 were measured in the serum samples from sepsis patients, those with septic shock at different time points (hospital admission, 3 and 7 days after hospital admission). The ratios of angiopoietin-1 to angiopoietin-2 levels (Ang-1/Ang-2 ratio) were calculated for each patient and control individual and were compared between groups (C). p values were calculated by using the Mann-Whitney U test.

Table 2. Correlation of Angiopoietin-2 levels with clinical parameters.

Clinical parameters	Correlation	Hospital admission	3 days after hospital admission	7 days after hospital admission
Mean arterial pressure (mmHg)	ρ (rho)	-0.42	-0.3	-0.15
	p value	<0.0001	0.012	0.52
White blood cells	ρ (rho)	0.08	0.19	0.06
	p value	0.51	0.18	0.7
Platelets (g/l)	ρ (rho)	-0.232	-0.57	-0.08
	p value	0.047	<0.0001	0.63
Hematocrit (%)	ρ (rho)	0.04	-0.02	-0.37
	p value	0.73	0.89	0.023
Total bilirubin (μmol/l)	ρ (rho)	0.37	0.51	0.33
	p value	0.0025	0.0003	0.059
Blood creatinine (μmol/l)	ρ (rho)	0.43	0.33	0.45
	p value	0.00012	0.011	0.003
Procalcitonin (ng/ml)	ρ (rho)	0.56	0.42	0.39
	p value	<0.0001	0.0004	0.008
Albumin (g/l)	ρ (rho)	-0.15	-0.18	-0.36
	p value	0.18	0.15	0.014
Lactate (mmol/l)	ρ (rho)	0.47	0.46	-0.17
	p value	0.0004	0.0024	0.54
SOFA score	ρ (rho)	0.41	-0.01	0.18
	p value	0.0002	0.93	0.2
APACHE II score	ρ (rho)	0.05	0.13	0.23
	p value	0.65	0.29	0.09

The correlations between the pair of studied parameters were calculated by using Spearman's rank correlation coefficient. Spearman's rho (ρ) and p values are presented.

Bold values are statistical significant.

Figure 3. Diagnostic performance of the angiopoietin levels for sepsis patients.

(A) Diagnostic performance of angiopoietin-1, (B) angiopoietin-2 (C) and the angiopoietin-1 to angiopoietin-2 (Ang-1/Ang-2) ratios for sepsis patients.

AUC: Area under curve.

Figure 4. Prognostic performance of the angiopoietin levels for septic shock.

(A) Prognostic performance of angiopoietin-1, (B) angiopoietin-2 (C) and the angiopoietin-1 to angiopoietin-2 (Ang-1/Ang-2) ratios in differentiating patients with septic shock from sepsis patients.

AUC: Area under curve.