Value of serum sTREM-1,D-lactate and I-FABP in diagnosis and prognosis evaluation in liver cirrhotic patients with sepsis

BackgroundSepsis is can cause serious negative effects among patients with cirrhosis.Finding reliable biomarker in early diagnose and prognosis in septic patients with liver cirrhosis is very important.We assessed value of serumsoluble triggering receptor expressed on myeloid cells-1 ( sTREM-1),D-lactate and Intestinal fatty acid binding protein(I-FABP) in diagnosis and prognosis evaluation in liver cirrhotic patients with sepsis.MethodsA prospective observational study of 158 cirrhosis patients was conducted. A total of 158cirrhosis patients were enrolled, 83 of whom were diagnosed with sepsis and 75 patients without sepsis during hospitalization.We evaluated value of early diagnostic and prognosis of cells-1(sTREM-1),D-lactate and I-FABP in cirrhotic patients with sepsis.Receiver operating characteristic curves (ROCs) were used to assess the ability of tested biomarkers to diagnose and prognosis cirrhotic patients with sepsis.ResultsOur results showed the CRP，PCT，sTREM-1, D-lactate and I-FABP were significantly higher in the sepsis group than in the no-sepsis group.,but only levels of serum sTREM-1 showed increasing trend with the severity of the cirrhotic patients with sepsis. The cutoff value of sTREM-1was 123.62 pg/mL and showed 84.3% sensitivity and 92.0% specificity and high accuracy in the early diagnosis for cirrhotic patients with sepsis.The AUC of sTREM-1 was 0.959(95%CI: 0.934–0. 985) and higher than that of CRP,PCT,D-lactate and I-FABP( P <0.001, P =0.002, P <0.001, P <0.001 respectively).Total 31(37.35%) cirrhotic patients with sepsis cases died during 90-day follow-up.Only sTREM-1 level had significance between survivors and non-survivors(263.99±213.79 vs 672.24±191.44,P=0.031).The AUCs of sTREM-1 for predicting 90-day mortality was 0.904( 95% CI:0.836-.971 ) and higher than that of CRP,PCT,D-lactate (P=0.001,p=0.003, P <0.001 respectively) The AUCs of I-FABP is only 0.482 and had no value of predicting prognosis.ConclusionSerum sTREM-1 is a valuable new biomarker for early diagnosis and prognosis in cirrhosis with sepsis, proving more accurate than CRP,PCT, D - lactate and I - FABP.Serum D-lactate and I-FABP levels can identify early cirrhosis with sepsis, but they is little relationship with the prognosis of patients.