Evaluation of diagnostic value of soluble urokinase-type plasminogen activator receptor in sepsis

Abstract

Background: Sepsis is one of the most important causes of morbidity and mortality in the intensive care units (ICUs). It is difficult to accurately differentiate sepsis from similar diseases rapidly. Therefore, it becomes critical to identify any biomarker with the ability of differentiation between sepsis and nonsepsis conditions. The urokinase plasminogen activator receptor has been implicated as an important factor in regulation of leukocyte adhesion and migration. Objectives: In this study, we evaluated the value of soluble urokinase plasminogen activator receptor (suPAR), erythrocyte sedimentation (ESR), and C-reactive protein (CRP) serum levels in terms of their value for sepsis diagnosis in ICU patients. Patients and Methods: We enrolled 107 ICU patients; 40 with sepsis, 43 with systemic inflammatory response syndrome, and 24 as control group. Serum soluble urokinase plasminogen activator receptor, ESR, white blood cell (WBC), and CRP levels were measured on the day of admission. Results: The group with sepsis had higher suPAR, ESR, and CRP levels compared with the group with noninfectious systemic inflammatory response syndrome (SIRS) (P = 0.01, 0.00 and 0.00, respectively). CRP concentrations and ESR were higher in the sepsis group than in the non-SIRS group (P = 0.00 and 0.00, respectively). In a receiver-operating characteristic curve analysis, ESR, CRP and suPAR had an area under the curve larger than 0.65 (P = 0.00) in distinguishing between septic and noninfectious SIRS patients. CRP, ESR and suPAR had a sensitivity of 87%, 71% and 66% and a specificity of 59%, 76% and 74% respectively in diagnosing infection in SIRS. Conclusions: The diagnostic values of CRP and ESR were better than suPAR and WBC count in patients with sepsis.