A prospective cohort study of severe sepsis-induced dyslipidemia and changes in D-dimer levels in children: do they affect the prognosis?
Abstract Background The dyslipidemia and changes in D-dimer values that occur in children with severe sepsis remain unidentified. Objective The current research aimed to explore the relationship between D-dimer and lipid profile values, including total cholesterol (TC), lipoproteins, apolipoprotein...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-12-01
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| Series: | Egyptian Pediatric Association Gazette |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43054-023-00240-4 |
| _version_ | 1827581767805042688 |
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| author | Tarek A. Abdelaziz Mohamed Ali Abdou Mohamed Weaam Ibrahim Ismail Ibrahim Ali Ibrahim Idreis Eman Gamal Baz |
| author_facet | Tarek A. Abdelaziz Mohamed Ali Abdou Mohamed Weaam Ibrahim Ismail Ibrahim Ali Ibrahim Idreis Eman Gamal Baz |
| author_sort | Tarek A. Abdelaziz |
| collection | DOAJ |
| description | Abstract Background The dyslipidemia and changes in D-dimer values that occur in children with severe sepsis remain unidentified. Objective The current research aimed to explore the relationship between D-dimer and lipid profile values, including total cholesterol (TC), lipoproteins, apolipoprotein A-V (Apo A-5), triglycerides (TG), and in-hospital nonsurvival in children with severe sepsis or septic shock in pediatric intensive care. Study design The study design is as follows: prospective cohort study. Participants Children with severe sepsis or septic shock who were admitted to the intensive care unit of a university pediatric hospital. Intervention Vital signs, sepsis assessment, pediatric sequential organ failure assessment (PSOFA) score, high-density lipoprotein (HDL), Apo A-5, TG, low-density lipoprotein (LDL), TC, D-dimer, mortality outcome, and pediatric risk of mortality (PRISM) III score were evaluated. Outcomes The primary outcome was in-hospital nonsurvival. Results The nonsurvivors had significantly higher D-dimer levels than the survivors, with a significant cutoff level of 0.87 μg/mL (AUC: 0.85, sensitivity: 93.3%, PVN: 90.6%, accuracy: 79.0%, PVP: 72.5%, and specificity: 64.7%). D-dimer was inversely correlated with WBC count and positively correlated with patient age, PRISM III score, PSOFA score, and INR. However, nonsurvivors had higher TG levels and lower TC, HDL, LDL, and Apo A-5 levels than survivors, but this variation was insignificant. Apo A-5 levels were inversely correlated with HDL and positively correlated with TG levels. Conclusions This study suggests that D-dimer is a promising biomarker for severe sepsis in children, with a mortality cutoff level of 0.87 μg/mL. However, lipid profiles are not predictors of sepsis-related mortality. |
| first_indexed | 2024-03-08T22:41:04Z |
| format | Article |
| id | doaj.art-2575f8c19d5a4b8387b1f2e7d7487dfb |
| institution | Directory Open Access Journal |
| issn | 2090-9942 |
| language | English |
| last_indexed | 2024-03-08T22:41:04Z |
| publishDate | 2023-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Egyptian Pediatric Association Gazette |
| spelling | doaj.art-2575f8c19d5a4b8387b1f2e7d7487dfb2023-12-17T12:09:54ZengSpringerOpenEgyptian Pediatric Association Gazette2090-99422023-12-017111910.1186/s43054-023-00240-4A prospective cohort study of severe sepsis-induced dyslipidemia and changes in D-dimer levels in children: do they affect the prognosis?Tarek A. Abdelaziz0Mohamed Ali Abdou Mohamed1Weaam Ibrahim Ismail2Ibrahim Ali Ibrahim Idreis3Eman Gamal Baz4Pediatric Department, Faculty of Medicine, Zagazig UniversityPediatric Department, Faculty of Medicine, Zagazig UniversityClinical Pathology Department, Faculty of Medicine, Zagazig UniversityPediatric Department, Faculty of Medicine, Zagazig UniversityPediatric Department, Faculty of Medicine, Zagazig UniversityAbstract Background The dyslipidemia and changes in D-dimer values that occur in children with severe sepsis remain unidentified. Objective The current research aimed to explore the relationship between D-dimer and lipid profile values, including total cholesterol (TC), lipoproteins, apolipoprotein A-V (Apo A-5), triglycerides (TG), and in-hospital nonsurvival in children with severe sepsis or septic shock in pediatric intensive care. Study design The study design is as follows: prospective cohort study. Participants Children with severe sepsis or septic shock who were admitted to the intensive care unit of a university pediatric hospital. Intervention Vital signs, sepsis assessment, pediatric sequential organ failure assessment (PSOFA) score, high-density lipoprotein (HDL), Apo A-5, TG, low-density lipoprotein (LDL), TC, D-dimer, mortality outcome, and pediatric risk of mortality (PRISM) III score were evaluated. Outcomes The primary outcome was in-hospital nonsurvival. Results The nonsurvivors had significantly higher D-dimer levels than the survivors, with a significant cutoff level of 0.87 μg/mL (AUC: 0.85, sensitivity: 93.3%, PVN: 90.6%, accuracy: 79.0%, PVP: 72.5%, and specificity: 64.7%). D-dimer was inversely correlated with WBC count and positively correlated with patient age, PRISM III score, PSOFA score, and INR. However, nonsurvivors had higher TG levels and lower TC, HDL, LDL, and Apo A-5 levels than survivors, but this variation was insignificant. Apo A-5 levels were inversely correlated with HDL and positively correlated with TG levels. Conclusions This study suggests that D-dimer is a promising biomarker for severe sepsis in children, with a mortality cutoff level of 0.87 μg/mL. However, lipid profiles are not predictors of sepsis-related mortality.https://doi.org/10.1186/s43054-023-00240-4D-dimerLipidMortalityPrognosisSeptic shockSevere sepsis |
| spellingShingle | Tarek A. Abdelaziz Mohamed Ali Abdou Mohamed Weaam Ibrahim Ismail Ibrahim Ali Ibrahim Idreis Eman Gamal Baz A prospective cohort study of severe sepsis-induced dyslipidemia and changes in D-dimer levels in children: do they affect the prognosis? Egyptian Pediatric Association Gazette D-dimer Lipid Mortality Prognosis Septic shock Severe sepsis |
| title | A prospective cohort study of severe sepsis-induced dyslipidemia and changes in D-dimer levels in children: do they affect the prognosis? |
| title_full | A prospective cohort study of severe sepsis-induced dyslipidemia and changes in D-dimer levels in children: do they affect the prognosis? |
| title_fullStr | A prospective cohort study of severe sepsis-induced dyslipidemia and changes in D-dimer levels in children: do they affect the prognosis? |
| title_full_unstemmed | A prospective cohort study of severe sepsis-induced dyslipidemia and changes in D-dimer levels in children: do they affect the prognosis? |
| title_short | A prospective cohort study of severe sepsis-induced dyslipidemia and changes in D-dimer levels in children: do they affect the prognosis? |
| title_sort | prospective cohort study of severe sepsis induced dyslipidemia and changes in d dimer levels in children do they affect the prognosis |
| topic | D-dimer Lipid Mortality Prognosis Septic shock Severe sepsis |
| url | https://doi.org/10.1186/s43054-023-00240-4 |
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