sTREM-1 is not suitable to discriminate survivors and nonsurvivors in surgical patients with severe sepsis or septic shock

Objectives

To evaluate in septic patients the plasma levels of sTREM-1, a soluble form of TREM-1, which seems to play an important role in inflammatory diseases, and to determine whether plasma sTREM-1 could be used as a diagnostic and prognostic marker in sepsis in the surgical ICU.

Design

An observational clinical study.

Setting

The surgical ICU of the University Hospital of Heidelberg, Germany.

Patients

Patients admitted to the ICU over a 6-month period with clinical evidence of severe sepsis or septic shock.

Interventions

None.

Measurements and results

Sixty-six intensive care patients were enrolled in the study within the first 24 hours after the onset of severe sepsis or septic shock. Twenty-one healthy individuals served as controls. At day 0, day 1 and day 3 after diagnosis of severe sepsis or septic shock, plasma sTREM-1 was measured by ELISA. Plasma sTREM-1 concentrations of healthy controls did not differ from patients with severe sepsis or septic shock at day 0 (42.8 ± 44.9 pg/ml vs 40.8 ± 45.5 pg/ml, not significant), day 1 (42.8 ± 44.9 pg/ml vs 48.6 ± 57.2 pg/ml, not significant) nor at day 3 (42.8 ± 44.9 pg/ml vs 51.9 ± 52.8 pg/ml, not significant). Survivors were defined as patients surviving to at least day 28. There were no differences of plasma sTREM-1 between survivors and nonsurvivors at day 0, day 1 and day 3 (34.8 ± 44 52.4 pg/ml vs 49.5 ± 35.9 pg/ml, 42.6 ± 61.1 pg/ml vs 59.6 ± 47.1 pg/ml, and 47.9 ± 60.2 pg/ml vs 58.2 ± 37.1 pg/ml, not significant).

Conclusion

In this study including surgical patients with severe sepsis or septic shock, plasma sTREM-1 is not elevated compared with healthy controls. Furthermore, the measurement of plasma sTREM-1 did not allow one to differ between survivors and nonsurvivors. The suggested role of sTREM-1 as a diagnostic and prognostic marker in sepsis was not confirmed in this study.