{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:28:22Z","timestamp":1789576102671,"version":"build-2803163510"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate whether serum levels of procalcitonin (PCT), D-dimer (D-D), and lactate dehydrogenase (LDH) are associated with disease severity and differ between patients with sepsis with favorable versus poor in-hospital outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included 171 patients with sepsis. Patients were stratified into a septic shock group (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f49) and a non-shock sepsis group (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f122) to assess disease severity and further categorized into an improved group (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f127) and a poor prognosis group (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f44) based on discharge outcomes to evaluate prognostic value. Univariate and multivariate logistic regression analyses were performed to identify independent factors associated with septic shock. Dynamic trajectories of PCT, D-D, and LDH levels during hospitalization were also analyzed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      On admission, levels of PCT, D-D, and LDH were significantly higher in the septic shock group than in the non-shock sepsis group (all\n                      <jats:italic>p\u202f&amp;lt;<\/jats:italic>\n                      \u202f0.01). In the multivariable model, elevated levels of PCT (OR\u202f=\u202f1.015, 95% CI: 1.002\u20131.028), D-D (OR\u202f=\u202f1.087, 95% CI: 1.010\u20131.170), and LDH (OR\u202f=\u202f1.265, 95% CI: 1.016\u20131.576) were independently associated with an increased likelihood of septic shock. Patients with a poor prognosis exhibited persistently elevated levels of all three biomarkers throughout hospitalization, whereas these levels decreased significantly in the improved group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PCT, D-D, and LDH are valuable biomarkers for stratifying disease severity and predicting clinical outcomes in patients with sepsis. Admission levels of these biomarkers were independently associated with the development of septic shock, and their dynamic changes provided additional prognostic information.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1771448","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T06:35:14Z","timestamp":1772433314000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Dynamic changes and prognostic utility of procalcitonin, D-dimer, and lactate dehydrogenase in patients with sepsis and septic shock"],"prefix":"10.3389","volume":"13","author":[{"given":"Qiuxia","family":"Ge","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, China"]},{"name":"Branch of National Clinical Research Center for Laboratory Medicine","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weijuan","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, China"]},{"name":"Branch of National Clinical Research Center for Laboratory Medicine","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, China"]},{"name":"Branch of National Clinical Research Center for Laboratory Medicine","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haojie","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, China"]},{"name":"Branch of National Clinical Research Center for Laboratory Medicine","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University","place":["Nanjing, China"]},{"name":"Branch of National Clinical Research Center for Laboratory Medicine","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.jhin.2023.05.022","article-title":"Prognostic significance of lymphocyte subpopulations for ICU-acquired infections in patients with sepsis: a retrospective study","volume":"140","author":"Zhao","year":"2023","journal-title":"J Hosp Infect"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1016\/j.jss.2018.03.035","article-title":"Lactate dehydrogenase is associated with 28-day mortality in patients with sepsis: a retrospective observational study","volume":"228","author":"Lu","year":"2018","journal-title":"J Surg Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"102958","DOI":"10.1016\/j.arr.2025.102958","article-title":"Protein post-translational modifications in sepsis: molecular mechanisms and biomarkers","volume":"114","author":"Wang","year":"2026","journal-title":"Ageing Res Rev"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000549235","article-title":"Immunomodulatory therapy and mortality in patients with sepsis: a meta-analysis","volume":"12","author":"Yu","year":"2025","journal-title":"Int Arch Allergy Immunol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1779","DOI":"10.1016\/j.resuscitation.2014.08.011","article-title":"Prognostication in comatose survivors of cardiac arrest: an advisory statement from the European resuscitation council and the European Society of Intensive Care Medicine","volume":"85","author":"Sandroni","year":"2014","journal-title":"Resuscitation"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e20220940","DOI":"10.1590\/1806-9282.20220940","article-title":"Serum galectin-3 levels predict poor prognosis in sepsis and septic shock patients","volume":"69","author":"Karabacak","year":"2023","journal-title":"Rev Assoc Med Bras"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e0137822","DOI":"10.1128\/spectrum.01378-22","article-title":"Clinical diagnostic performance of droplet digital PCR for suspected bloodstream infections","volume":"11","author":"Lin","year":"2023","journal-title":"Microbiol Spectrum"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s13054-021-03862-5","article-title":"Biomarkers for sepsis: more than just fever and leukocytosis-a narrative review","volume":"26","author":"Barichello","year":"2022","journal-title":"Crit Care"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"5852","DOI":"10.1002\/jcb.27870","article-title":"The diagnostic accuracy of procalcitonin and C-reactive protein for sepsis: a systematic review and meta-analysis","volume":"120","author":"Tan","year":"2019","journal-title":"J Cell Biochem"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"221015","DOI":"10.7754\/Clin.Lab.2022.221015","article-title":"D-dimer levels and the disseminated intravascular coagulation score to predict severity and outcomes in sepsis or septic shock","volume":"69","author":"Schupp","year":"2023","journal-title":"Clin Lab"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"4251","DOI":"10.1186\/s12872-024-04251-w","article-title":"LDHA exacerbates myocardial ischemia-reperfusion injury through inducing NLRP3 lactylation","volume":"24","author":"Fang","year":"2024","journal-title":"BMC Cardiovasc Disord"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1016\/j.it.2021.04.001","article-title":"Emerging mechanisms of immunocoagulation in sepsis and septic shock","volume":"42","author":"Tang","year":"2021","journal-title":"Trends Immunol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1038\/s41392-021-00816-9","article-title":"Signaling pathways and intervention therapies in sepsis","volume":"6","author":"Zhang","year":"2021","journal-title":"Signal Transduct Target Ther"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"105600","DOI":"10.5492\/wjccm.v14.i4.105600","article-title":"Retrospective evaluation of efficacy of CytoSorb\u00ae therapy in septic shock patients in a tertiary care intensive care unit","volume":"14","author":"Shah","year":"2025","journal-title":"World J Crit Care Med."},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-025-05872-5","article-title":"Prognostic significance of immune abnormalities in children with severe sepsis","author":"Das","year":"2025","journal-title":"Indian J Pediatr"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1679297","DOI":"10.3389\/fmed.2025.1679297","article-title":"Prognostic utility of procalcitonin and lactate clearance for in-hospital mortality in sepsis","volume":"12","author":"Diab","year":"2025","journal-title":"Front Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.2147\/IJGM.S402586","article-title":"Relationship between the expression of PD-1 and CTLA-4 on T lymphocytes and the severity and prognosis of Sepsis","volume":"16","author":"Wang","year":"2023","journal-title":"Int J Gen Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e24428","DOI":"10.1002\/jcla.24428","article-title":"MALAT1 regulates PCT expression in sepsis patients through the miR-125b\/STAT3 axis","volume":"36","author":"Le","year":"2022","journal-title":"J Clin Lab Anal"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s13643-023-02432-w","article-title":"Accuracy of procalcitonin for diagnosing sepsis in adult patients admitted to the emergency department: a systematic review and meta-analysis","volume":"13","author":"Zaki","year":"2024","journal-title":"Syst Rev"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"139","DOI":"10.5492\/wjccm.v11.i3.139","article-title":"Plasma D-dimer level in early and late-onset neonatal sepsis","volume":"11","author":"Al-Biltagi","year":"2022","journal-title":"World J Crit Care Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.thromres.2018.12.003","article-title":"Low D-dimer levels in sepsis: good or bad?","volume":"174","author":"Semeraro","year":"2019","journal-title":"Thromb Res"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.3760\/cma.j.cn121430-20240426-00386","volume":"36","author":"Li","year":"2024","journal-title":"Zhonghua Wei Zhong Bing Ji Jiu Yi Xue"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2212080","DOI":"10.1080\/0886022X.2023.2212080","article-title":"The association between lactate dehydrogenase to serum albumin ratio and the 28-day mortality in patients with sepsis-associated acute kidney injury in intensive care: a retrospective cohort study","volume":"45","author":"Liang","year":"2023","journal-title":"Ren Fail"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1038\/s41419-023-05952-4","article-title":"PDHA1 hyperacetylation-mediated lactate overproduction promotes sepsi-induced acute kidney injury via Fis1 lactylation","volume":"14","author":"An","year":"2023","journal-title":"Cell Death Dis"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1186\/s12879-023-08636-8","article-title":"One-year mortality prediction for patients with sepsis: a nomogram integrating lactic dehydrogenase and clinical characteristics","volume":"23","author":"Wang","year":"2023","journal-title":"BMC Infect Dis"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1771448\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T06:35:17Z","timestamp":1772433317000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1771448\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,2]]},"references-count":25,"alternative-id":["10.3389\/fmed.2026.1771448"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1771448","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,2]]},"article-number":"1771448"}}