Diagnostic and Predictive Values of Soluble Triggering Receptor Expressed on Myeloid Cells-1 in Sepsis: A Multi-Center Prospective Clinical Study.

Objective: To determine diagnostic values of serum and urine soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in sepsis including septic shock and their predictive values for clinical prognosis and sepsis-associated acute kidney injury (AKI). Methods: A multi-center prospective research method was used to enroll patients with sepsis. Results: A total of 586 cases were studied, including 238 patients with sepsis and 348 healthy individuals. In the sepsis group, 84 patients (35.3%) were diagnosed with septic shock, and 93 patients (38.1%) were diagnosed with AKI. The area under the Receiver Operating Characteristic curve (AUC) for diagnosing sepsis was 0.892 (0.862-0.922). When the cut-off value was 295 pg/mL, the sensitivity was 76.8%, and the specificity was 89.1%. The AUC for predicting AKI was 0.803 (0.739-0.866). When the cut-off value was 485 pg/mL, the sensitivity was 88.4%, and the specificity was 65.8%. Conclusion: sTREM-1 is a good indicator for the diagnosis of sepsis and septic shock and significantly correlated with clinical prognosis and sepsis-associated AKI in patients with sepsis. Diagnostic and predictive values of sTREM-1 may be related to inflammatory storm mediated by TREM-1. Further mechanistic explanation or preliminary evidence in combination with clinical study with more patients will benefit for supporting diagnostic and predictive utilities of sTREM-1 in sepsis.