Assessment of S100A8/A9 and Resistin as predictive biomarkers for mortality in critically ill patients with sepsis

Jing Chen¹Fan Zhou¹Ye Sun¹Zhenyou Jiang²Pingsen Zhao^1*

• ¹Yuebei People's Hospital, Shaoguan, China
• ²Jinan University, Guangzhou, Guangdong Province, China

Objectives: Sepsis is associated with high mortality. This study aims to assess the clinical potential of S100A8/A9 and resistin as novel biomarkers for predicting mortality risk in sepsis patients. Method: Serum samples were collected and analyzed from 141 adult sepsis patients (discovery cohort), 43 non-sepsis intensive care units (ICU) patients, 15 healthy volunteers, and 55 sepsis patients along with 17 non-sepsis ICU patients (validation cohort). The 28-day mortality and sequential organ failure assessment (SOFA) scores of the participants were compared. Additionally, the predictive ability of S100A8/A9 and resistin for sepsis mortality was evaluated using the area under the receiver operating characteristic curve at ICU admission. Results: The concentrations of S100A8/A9 and resistin in sepsis patients were noticeably increased relative to non-sepsis patients and healthy controls. Serum S100A8/A9 concentrations in surviving sepsis patients were significantly higher than in non-surviving patients. On the day of admission, serum resistin concentrations in Gram-negative (G-) sepsis patients were considerably elevated relative to Gram-positive (G+) infected sepsis patients. Among sepsis patients admitted to the ICU, the AUC for S100A8/A9 in predicting 28-day mortality was 0.617 (P = 0.032; 95% confidence bounds 0.513–0.721), and for SOFA was 0.750 (P < 0.0001; 95% confidence bounds 0.660–0.840). Sepsis patients with high serum S100A8/A9 concentrations (≥ 377.53 ng/mL) had a higher survival rate relative to those with low concentrations (<377.53 ng/mL). In the validation cohort, the AUC for S100A8/A9 and 28-day mortality was 0.708 (P = 0.032; 95% confidence bounds 0.563–0.854), and for SOFA was 0.698 (P = 0.025; 95% confidence bounds 0.550–0.845). Additionally, sepsis patients with high serum S100A8/A9 concentrations (≥ 377.53 ng/mL) also had a higher survival rate relative to those with lower concentrations (< 377.53 ng/mL). Furthermore, serum resistin levels in patients with a normal phenotype and mixed phenotype with hyperinflammation were predictive of mortality, with an AUC of 0.810 (P = 0.034; 95% confidence bounds 0.605–1.00) and 0.708 (P = 0.015; 95% confidence bounds 0.571–0.846). In patients with a normal sepsis phenotype, those with high serum resistin