PB1159 - Tissue-Type Plasminogen Activator-Inhibitor Complex as an Early Predictor of septic liver injury: A Retrospective, SingleCenter Study

Tuesday, June 25, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Longping He, MA

the 908th Hospital of Chinese Logistical Support Force,Nanchang, China
Department of Critical Care Medicine, the 908th Hospital of Chinese Logistical Support Force, Nanchang, China,Nanchang Key Laboratory of Thrombosis and Hemostasis, Nanchang , China
Nanchang, Jiangxi, China (People's Republic)

Co-Author(s)

Qingwei Lin, MA

the 908th Hospital of Chinese Logistical Support Force,Nanchang, China
Department of Critical Care Medicine, the 908th Hospital of Chinese Logistical Support Force, Nanchang 330002, China 2 Nanchang Key Laboratory of Thrombosis and Hemostasis, Nanchang 330002, China
Nanchang, Jiangxi, China (People's Republic)
LZ

Lincui Zhong

the 908th Hospital of Chinese Logistical Support Force,Nanchang, China
Department of Critical Care Medicine, the 908th Hospital of Chinese Logistical Support Force, Nanchang 330002, China 2 Nanchang Key Laboratory of Thrombosis and Hemostasis, Nanchang 330002, China
Nanchang, Jiangxi, China (People's Republic)
JS

Jingchun Song

the 908th Hospital of Chinese Logistical Support Force,Nanchang, China
Department of Critical Care Medicine, the 908th Hospital of Chinese Logistical Support Force, Nanchang 330002, China 2 Nanchang Key Laboratory of Thrombosis and Hemostasis, Nanchang 330002, China
Nanchang, Jiangxi, China (People's Republic)

Background: Sepsis is characterized by a dysregulated immune response to infection leading to life-threatening organ dysfunction.Sepsis-induced liver injury is recognized as a powerful independent predictor of mortality in the intensive care unit.Mortality rates among sepsis patients with liver dysfunction or failure range from 54 to 68%, which is higher than the mortality rates of sepsis patients with lung dysfunction or failure (the organ most commonly affected in sepsis) .

Aims: This study explored whether levels of tissue-type plasminogen activator-inhibitor complex (t-PAIC) in serum can predict septic liver injury.

Methods: We carried out a retrospective, single-center study of 546 patients with sepsis admitted to an intensive care unit at a comprehensive hospital between May 2018 and December 2022.Conventional coagulation tests (CCTs) and coagulation molecular markers were performed within 2 hours of admission in ICU and we divided them into those who progressed to septic liver injury (n=173) or not (n=373) based on sepsis-3 definition and multiple organ dysfunction score. we screened for risk factors of septic liver injury using random forest analysis. We assessed potential predictors of such liver injury based on the area under the receiver-operating characteristic curve (AUC), Kaplan-Meier survival curves, and correlation analysis.

Results: Random forest analysis identified t-PAIC as an independent risk factor for septic liver injury and a biomarker that predicted it with an AUC up to 0.862 (95%CI, 0.832-0.892). Based on the optimal cut-off of t‐PAIC = 11.9 ng/mL,we found that patients at or above this threshold had significantly higher lactate levels and scores on the Acute Physiology and Chronic Health Evaluation II (APACHE II)( P < 0.001) .Such patients had significantly worse survival (HR 2.223, 95%CI 1.584–3.119, P < 0.001).

Conclusion(s): Serum levels of t-PAIC may be an independent risk factor for septic liver injury and may be useful in clinical decision making.