Maximal Chemiluminescent Intensity in Response to Lipopolysaccharide Assessed by Endotoxin Activity Assay on Admission Day Predicts Mortality in Patients With Sepsis

OBJECTIVE:Sepsis is the leading cause of death among critically ill patients. There are, however, few appropriate biomarkers to predict mortality in patients with sepsis. We focused on maximal chemiluminescent intensity in response to lipopolysaccharide assessed by endotoxin activity assay and evaluated the diagnostic value of maximal chemiluminescent intensity on admission day as a predictor of mortality in patients with sepsis. DESIGN:Prospective, observational study. SETTING:ICU. PATIENTS:One hundred and thirty-two patients with sepsis. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Within 12 hours after admission, a whole-blood sample was collected, and variables assessed by endotoxin activity assay were measured in each patient. Severity of illness was assessed simultaneously by Acute Physiology and Chronic Health Evaluation (APACHE) II score and Sequential Organ Failure Assessment (SOFA) score. The primary outcome was 28-day mortality. One hundred and fifteen patients survived and 17 died. maximal chemiluminescent intensity values were significantly lower in the nonsurvivors than in the survivors (p