{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T23:45:46Z","timestamp":1769557546404,"version":"3.49.0"},"reference-count":56,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T00:00:00Z","timestamp":1723766400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Iuliu Ha\u021bieganu University of Medicine and Pharmacy, Cluj-Napoca","award":["2461\/42\/17.01.2020"],"award-info":[{"award-number":["2461\/42\/17.01.2020"]}]},{"name":"Iuliu Ha\u021bieganu University of Medicine and Pharmacy, Cluj-Napoca","award":["1033\/40\/13.01.2021"],"award-info":[{"award-number":["1033\/40\/13.01.2021"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Sepsis represents a global health challenge and requires advanced diagnostic and prognostic approaches due to its elevated rate of morbidity and fatality. Our study aimed to assess the value of a novel set of six biomarkers combined with severity scores in predicting 28 day mortality among patients presenting with sepsis in the Emergency Department (ED). Materials and Methods: This single-center, observational, prospective cohort included sixty-seven consecutive patients with septic shock and sepsis enrolled from November 2020 to December 2022, categorized into survival and non-survival groups based on outcomes. The following were assessed: procalcitonin (PCT), soluble Triggering Receptor Expressed on Myeloid Cells-1 (sTREM-1), the soluble form of the urokinase plasminogen activator receptor (suPAR), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and azurocidin 1 (AZU1), alongside clinical scores such as the Quick Sequential Organ Failure Assessment (qSOFA), Systemic Inflammatory Response Syndrome (SIRS), the Sequential Organ Failure Assessment (SOFA), the Acute Physiology and Chronic Health Evaluation II (APACHE II), the Simplified Acute Physiology Score II and III (SAPS II\/III), the National Early Warning Score (NEWS), Mortality in Emergency Department Sepsis (MEDS), the Charlson Comorbidity Index (CCI), and the Glasgow Coma Scale (GCS). The ability of each biomarker and clinical score and their combinations to predict 28 day mortality were evaluated. Results: The overall mortality was 49.25%. Mechanical ventilation was associated with a higher mortality rate. The levels of IL-6 were significantly higher in the non-survival group and had higher AUC values compared to the other biomarkers. The GCS, SOFA, APACHEII, and SAPS II\/III showed superior predictive ability. Combining IL-6 with suPAR, AZU1, and clinical scores SOFA, APACHE II, and SAPS II enhanced prediction accuracy compared with individual biomarkers. Conclusion: In our study, IL-6 and SAPS II\/III were the most accurate predictors of 28 day mortality for sepsis patients in the ED.<\/jats:p>","DOI":"10.3390\/medicina60081333","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T12:40:07Z","timestamp":1723812007000},"page":"1333","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Can We Improve Mortality Prediction in Patients with Sepsis in the Emergency Department?"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1882-4087","authenticated-orcid":false,"given":"Sonia","family":"Luka","sequence":"first","affiliation":[{"name":"Department 6 Surgery, Discipline of Emergency Medicine, Iuliu Hatieganu, Faculty of Medicine, University of Medicine and Pharmacy, 3\u20135 Clinicilor Street, 400347 Cluj-Napoca, Romania"},{"name":"Clinical Emergency County Hospital, 3\u20135 Clinicilor Street, 400347 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7227-2326","authenticated-orcid":false,"given":"Adela","family":"Golea","sequence":"additional","affiliation":[{"name":"Department 6 Surgery, Discipline of Emergency Medicine, Iuliu Hatieganu, Faculty of Medicine, University of Medicine and Pharmacy, 3\u20135 Clinicilor Street, 400347 Cluj-Napoca, Romania"},{"name":"Clinical Emergency County Hospital, 3\u20135 Clinicilor Street, 400347 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u0218tefan Cristian","family":"Vesa","sequence":"additional","affiliation":[{"name":"Department 1 Functional Sciences, Discipline of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 23 Marinescu Street, 400337 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Crina-Elena","family":"Leahu","sequence":"additional","affiliation":[{"name":"Clinical Emergency County Hospital, 3\u20135 Clinicilor Street, 400347 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raluca","family":"Z\u0103g\u0103nescu","sequence":"additional","affiliation":[{"name":"Clinical Emergency County Hospital, 3\u20135 Clinicilor Street, 400347 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2847-537X","authenticated-orcid":false,"given":"Daniela","family":"Ionescu","sequence":"additional","affiliation":[{"name":"Department 6 Surgery, Discipline of Anesthesia and Intensive Care I, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 19\u201321 Croitorilor Street, 400162 Cluj-Napoca, Romania"},{"name":"Department of Anesthesia and Intensive Care, The Regional Institute of Gastroenterology and Hepatology, \u201cProf. Dr. Octavian Fodor\u201d, 19\u201321 Croitorilor Street, 400162 Cluj-Napoca, Romania"},{"name":"Research Association in Anesthesia and Intensive Care (ACATI), 400394 Cluj-Napoca, Romania"},{"name":"Outcome Research Consortium, Cleveland, OH 44195, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"154096","DOI":"10.1016\/j.jcrc.2022.154096","article-title":"Hospital-Related costs of sepsis around the world: A systematic review exploring the economic burden of sepsis","volume":"71","author":"Bouma","year":"2022","journal-title":"J. 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