Background: Despite improved risk stratification tools and identification of novel biomarkers, sepsis-related mortality has not significantly improved during the past years. Objective: This study investigates the diagnostic and prognostic role of the serum albumin and cholinesterase (ChE) in patients with sepsis and septic shock. Methods: Consecutive patients with sepsis and septic shock from 2019 to 2021 were included. Blood samples were retrieved from day of disease onset (day 1), day 2,3,5 and 7. Firstly, the diagnostic value of the serum albumin for the diagnosis of a septic shock was compared to the ChE. Secondly, the prognostic value of the serum albumin and the ChE for 30-day all-cause mortality was tested. Results: A total of 239 patients were included. With an area under the curve (AUC) of 0.641 to 0.762 on day 3 and 5, the ChE revealed a moderate but better diagnostic discrimination between sepsis and septic shock than the serum albumin. Furthermore, the ChE was able to discriminate between non-survivors and survivors of the 30-day time inter-val (range of AUC 0.612 to 0.686). Patients with a ChE below the median had higher rates of 30-days all-cause mortality in comparison to patients with a ChE above the median (65% vs. 42%, log rank p = 0.001; HR = 1.820; 95% CI 1.273 – 2.601; p = 0.001). Conclusion: The ChE reflects a reliable diagnostic and prognostic tool in patients with sepsis and septic shock.


中文翻译：

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脓毒症和感染性休克患者血清白蛋白和胆碱酯酶的诊断和预后表现

背景：尽管风险分层工具得到改进并识别出新型生物标志物，但脓毒症相关死亡率在过去几年中并未显着改善。目的：本研究探讨血清白蛋白和胆碱酯酶（ChE）在脓毒症和脓毒性休克患者中的诊断和预后作用。方法：纳入 2019 年至 2021 年连续发生脓毒症和脓毒性休克的患者。从发病当天（第1天）、第2、3、5和7天采集血样。首先，将血清白蛋白对感染性休克的诊断价值与ChE进行比较。其次，测试了血清白蛋白和 ChE 对 30 天全因死亡率的预后价值。结果：共纳入239例患者。第 3 天和第 5 天的曲线下面积 (AUC) 为 0.641 至 0.762，ChE 显示脓毒症和感染性休克之间的诊断区分度中等，但比血清白蛋白更好。此外，ChE 能够区分 30 天时间间隔的非幸存者和幸存者（AUC 范围为 0.612 至 0.686）。与 ChE 高于中位数的患者相比，ChE 低于中位数的患者 30 天全因死亡率更高（65% vs. 42%，对数秩 p = 0.001；HR = 1.820；95% CI 1.273 – 2.601；p = 0.001）。结论：ChE 是脓毒症和感染性休克患者可靠的诊断和预后工具。与 ChE 高于中位数的患者相比，ChE 低于中位数的患者 30 天全因死亡率更高（65% vs. 42%，对数秩 p = 0.001；HR = 1.820；95% CI 1.273 – 2.601；p = 0.001）。结论：ChE 是脓毒症和感染性休克患者可靠的诊断和预后工具。与 ChE 高于中位数的患者相比，ChE 低于中位数的患者 30 天全因死亡率更高（65% vs. 42%，对数秩 p = 0.001；HR = 1.820；95% CI 1.273 – 2.601；p = 0.001）。结论：ChE 是脓毒症和感染性休克患者可靠的诊断和预后工具。