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Prediction of prognosis in sepsis patients by the SOFA score combined with miR-150.

BACKGROUND
The sequential organ failure assessment (SOFA) score, designed to evaluate sepsis-associated organ dysfunction in intensive care unit (ICU) patients, is associated with the prognosis of sepsis patients. MicroRNA-150 (miR-150) is one of the first miRs to be detected in patients with sepsis and other critical illnesses, and to have an association with the prognosis of critical illness and sepsis.


OBJECTIVES
To assess the predictive value of the combination of the SOFA score and miR-150 levels for the prognosis of sepsis patients.


MATERIAL AND METHODS
We retrospectively included 437 adult patients with sepsis who were divided into a death group (n = 138, 31.6%) and a survival group (n = 299, 68.4%), according to their survival status at the 28-day follow-up. Binary logistic regression was performed to identify independent associations. Receiver operator characteristic (ROC) curve was employed to assess the predictive values. The Z-test was used to compare the area under curve (AUC).


RESULTS
Multivariate analysis demonstrated that miR-150 (odds ratio (OR): 0.549, 95% confidence interval (95% CI) [0.372, 0.826], p < 0.001), the SOFA score (OR: 1.216, 95% CI [1.039, 1.807], p = 0.008), age, procalcitonin (PCT), and septic shock were independently associated with 28-day mortality of sepsis patients following the adjustment for chronic renal failure, hypertension, diabetes mellitus, activated partial thromboplastin time (APTT), serum creatinine (SCr), blood urea nitrogen (BUN), and total bilirubin (TBil). The AUC of miR-150, the SOFA score and their combination in predicting the 28-day mortality of sepsis patients was 0.762 (standard error (SE): 0.023, 95% CI [0.717, 0.808]), 0.735 (SE: 0.025, 95% CI [0.687, 0.784]) and 0.886 (SE: 0.015, 95% CI [0.857, 0.916]), respectively. The AUC of their combined prediction was significantly greater than the independent prediction (0.886 compared to 0.762, Z = 4.516, p < 0.001; 0.886 compared to 0.735, Z = 5.179, p < 0.001). The sensitivity and specificity of combination prediction were 86.2% and 80.6%, respectively.


CONCLUSIONS
The combination of the SOFA score and miR-150 could improve the prediction of prognosis in sepsis patients.