Prognostic value of phospholipase A(2) group II, C-reactive protein and simplified acute physiological score II in intensive care patients

Abstract

We investigated the prognostic value of group II phospholipase A(2) (PLA(2)-II) and C-reactive protein (CRP) in patients of the intensive care unit (ICU) who developed severe inflammatory reaction. In addition, the biochemical markers were correlated with the Simplified Acute Physiological Score II (SAPS II). Our study comprised 40,patients with multiple injuries and 35 patients with sepsis admitted to the ICU, and assessed during a follow-up of as long as 28 days. There were 18 survivors and 17 non-survivors in the sepsis group, and 22 survivors and 18 non-survivors in the group of patients with multiple injuries. In the group of patients with multiple injuries, the intensity of host inflammatory response showed clearly distinct PLA(2)-II and CRP profiles: the overall levels of PLA(2)-II and CRP were significantly higher in non-survivors than in survivors. PLA(2)-II and CRP do not discriminate non-survivors from survivors with sepsis. ROC (receiver operating characteristic curve) analysis and the area under the curve (AUC) showed the best classification of polytrauma patients with SAPS 11 and PLA(2)-II. In the group of patients with sepsis, only SAPS II appeared to be the most helpful predictive measure regarding patient outcome.