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

J Crit Care. 2016 Feb;31(1):68-75. doi: 10.1016/j.jcrc.2015.09.019. Epub 2015 Sep 25.

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.

Keywords: Diagnosis; Endocan; Intensive care unit; Prognosis; Septic shock; Severe sepsis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Calcitonin / blood
  • Calcitonin Gene-Related Peptide
  • Female
  • Humans
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Neoplasm Proteins / blood*
  • Predictive Value of Tests
  • Prognosis
  • Protein Precursors / blood
  • Proteoglycans / blood*
  • Regression Analysis
  • Sepsis / blood*
  • Sepsis / mortality
  • Shock, Septic / blood*
  • Shock, Septic / diagnosis
  • Shock, Septic / mortality
  • Systemic Inflammatory Response Syndrome / blood

Substances

  • Biomarkers
  • CALCA protein, human
  • ESM1 protein, human
  • Interleukin-6
  • Neoplasm Proteins
  • Protein Precursors
  • Proteoglycans
  • Calcitonin
  • Calcitonin Gene-Related Peptide