Jacobs Journal of Emergency Medicine

New Biomarkers in the Management of Sepsis in the Emergency Department: Role of Galectin-3

Published on: 2016-05-27

Abstract

Purpose To evaluate the diagnostic and prognostic role of Galectin-3 as compared to Procalcitonin in patients presenting to the Emergency Department with SIRS and either suspected infection or not. Methods Multicenter observational study including 163 patients (final diagnosis was sepsis in 37, severe sepsis/septic shock in 94 and SIRS in 32 who served as the control group). Blood samples were collected at the first medical assessment and analyzed using the Galectin-3 Vidas® assay. Definitive diagnosis and 30 days in-hospital mortality were obtained from the analysis of digital medical records. Results Galectin-3 distinguished the population with severe sepsis/septic shock (median plasma concentration 31.3 ng/mL, 95% CI 25.5-37.4) from patients with sepsis (20.2 ng/mL, 15.1-25.5)(p=0.007) but not from patients with SIRS (25.4 ng/mL, 17.4-41.8). The Area under the ROC curve of Galectin-3 was 0.70 (95% CI 0.61-0.77) and the best combination of sensitivity (79.6%, 95% CI 69.9-87.2) and specificity (55.6%, 38.1-72.1) was detected at Galectin-3 threshold of 20.7 ng/mL. Galectin-3 concentrations were correlated with leukocytes (p=0.0003), lactate (p=0.026) and PCT (p=0.0003). In patients with poor prognosis Galectin-3 values were higher and Galectin-3 was the only statistically significant prognostic factor according to Cox regression analysis, when combined with other clinical and laboratory parameters.

Keywords

Sepsis, Biomarkers, Galectin-3, Procalcitonin, Emergency Department