Peripheral Blood Levels of IL-27, IFABP, and DAO at Early Onset as Predictors of 28-Day Mortality in Enterogenic Sepsis Patients: A Single-Center, Prospective Pilot Study.

Abstract

Background: Currently, there is a lack of serum biomarkers that can accurately predict the short-term prognosis of enterogenic sepsis.

Methods: 99 patients with enterogenic sepsis were categorized based on their Acute Gastrointestinal Injury (AGI) grade on the third day of ICU admission into four groups: no AGI, AGI grade I, AGI grade II, and AGI (III+IV). Additionally, patients were classified into survival and death groups according to their 28-day clinical outcomes. Peripheral venous blood samples were collected to measure levels of interleukin (IL)-27, intestinal fatty acid-binding protein (IFABP), and diamine oxidase (DAO). Receiver operating characteristic (ROC) curves were generated to assess the ability of IL-27, IFABP, and DAO to predict the short-term prognosis of patients with enterogenic sepsis.

Results: On the third day, both the survival and death groups exhibited elevated serum levels of IL-27 and IFABP compared to the first day, while levels of DAO were lower than those observed on day one. Furthermore, a significant positive correlation was observed between IL-27 and both IFABP and DAO, with stronger correlations evident on day three compared to day one. As the Acute Gastrointestinal Injury (AGI) grading increased, levels of IL-27, IFABP, and DAO rose correspondingly, correlating with a gradual decrease in survival rates, all demonstrating statistical significance (all P < 0.05). The Area Under the Curve (AUC) values for IL-27, IFABP, and DAO on the third day, predicting short-term prognosis for intestinal sepsis patients, were 0.714, 0.772, and 0.724, respectively. Notably, these values surpassed those of the first day, with IFABP on the third day exhibiting the highest predictive capability.

Conclusion: IL-27, IFABP, and DAO levels measured on the third day of hospitalization can accurately predict the short-term prognosis of enterogenic sepsis.