What is the correlation between plasma Pentraxin‑3 (PTX3) levels and Sequential Organ Failure Assessment (SOFA) scores in critically ill adults with sepsis or septic shock?

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Correlation Between PTX3 and SOFA Scores

PTX3 levels demonstrate a significant positive correlation with SOFA scores in critically ill patients with sepsis and septic shock, with higher PTX3 concentrations directly corresponding to greater organ dysfunction severity.

Quantitative Correlation Evidence

The relationship between PTX3 and SOFA scores has been directly established through correlation analysis:

  • Pearson's correlation analysis demonstrates that PTX3 levels are positively correlated with SOFA scores (P <0.01), indicating that as PTX3 rises, organ dysfunction severity increases proportionally 1.

  • This correlation exists alongside similar relationships with APACHE II scores, confirming PTX3's role as a marker of overall disease severity 1.

Clinical Significance of the Correlation

The PTX3-SOFA relationship has important prognostic implications:

  • PTX3 levels rise progressively with the number and severity of organ dysfunctions, with the highest concentrations observed in patients with septic shock 2.

  • Higher baseline PTX3 concentrations predict the subsequent development of new organ failures, suggesting PTX3 elevation precedes worsening SOFA scores 2.

  • Patients with elevated PTX3 levels (above median values) demonstrate significantly lower 28-day survival rates, independent of initial SOFA scores 3.

Temporal Dynamics

The correlation between PTX3 and organ dysfunction evolves over time:

  • PTX3 concentrations typically decrease from day 1 to day 7 in survivors, but this decline is less pronounced in patients with septic shock and persistent organ dysfunction 2.

  • Smaller drops in PTX3 over time predict higher 90-day mortality, suggesting that persistent elevation reflects ongoing organ damage 2.

  • Serial PTX3 measurements on days 0,3, and 7 consistently show higher levels in non-survivors compared to survivors, paralleling SOFA score trajectories 1.

Comparative Prognostic Value

PTX3 demonstrates robust predictive capacity for mortality outcomes:

  • In multivariate Cox regression analysis, PTX3 emerges as an independent predictor of 28-day mortality (hazard ratio = 3.87; 95% CI: 1.66-8.81, P = 0.004), even when controlling for SOFA scores 3.

  • PTX3 measured on day 7 predicts 90-day mortality in fully adjusted models that account for organ dysfunction severity 2.

  • The combination of PTX3 with other biomarkers (PCT and lactate) performs better than individual markers for mortality prediction, suggesting complementary prognostic information beyond SOFA scores alone 1.

Disease Severity Stratification

PTX3 effectively discriminates between different sepsis severity categories:

  • PTX3 levels show a clear gradient from systemic inflammatory response syndrome to sepsis to septic shock, with the highest concentrations in patients with the most severe organ dysfunction 4.

  • PTX3 can classify disease severity and predict 90-day mortality based on Sepsis 3.0 definitions, which incorporate SOFA score criteria 5.

  • The correlation with SOFA scores (P = 0.00097 with APACHE II as proxy for severity) suggests PTX3 directly reflects tissue involvement in inflammatory and infectious processes 4.

References

2
Research

Pentraxin 3 in patients with severe sepsis or shock: the ALBIOS trial.

European journal of clinical investigation, 2017

3
Research

Pentraxin 3, a Predicator for 28-Day Mortality in Patients With Septic Shock.

The American journal of the medical sciences, 2017

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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