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An integrated clinico-metabolomic model improves prediction of death in sepsis.


ABSTRACT: Sepsis is a common cause of death, but outcomes in individual patients are difficult to predict. Elucidating the molecular processes that differ between sepsis patients who survive and those who die may permit more appropriate treatments to be deployed. We examined the clinical features and the plasma metabolome and proteome of patients with and without community-acquired sepsis, upon their arrival at hospital emergency departments and 24 hours later. The metabolomes and proteomes of patients at hospital admittance who would ultimately die differed markedly from those of patients who would survive. The different profiles of proteins and metabolites clustered into the following groups: fatty acid transport and ?-oxidation, gluconeogenesis, and the citric acid cycle. They differed consistently among several sets of patients, and diverged more as death approached. In contrast, the metabolomes and proteomes of surviving patients with mild sepsis did not differ from survivors with severe sepsis or septic shock. An algorithm derived from clinical features together with measurements of five metabolites predicted patient survival. This algorithm may help to guide the treatment of individual patients with sepsis.

SUBMITTER: Langley RJ 

PROVIDER: S-EPMC3924586 | biostudies-literature | 2013 Jul

REPOSITORIES: biostudies-literature

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An integrated clinico-metabolomic model improves prediction of death in sepsis.

Langley Raymond J RJ   Tsalik Ephraim L EL   van Velkinburgh Jennifer C JC   Glickman Seth W SW   Rice Brandon J BJ   Wang Chunping C   Chen Bo B   Carin Lawrence L   Suarez Arturo A   Mohney Robert P RP   Freeman Debra H DH   Wang Mu M   You Jinsam J   Wulff Jacob J   Thompson J Will JW   Moseley M Arthur MA   Reisinger Stephanie S   Edmonds Brian T BT   Grinnell Brian B   Nelson David R DR   Dinwiddie Darrell L DL   Miller Neil A NA   Saunders Carol J CJ   Soden Sarah S SS   Rogers Angela J AJ   Gazourian Lee L   Fredenburgh Laura E LE   Massaro Anthony F AF   Baron Rebecca M RM   Choi Augustine M K AM   Corey G Ralph GR   Ginsburg Geoffrey S GS   Cairns Charles B CB   Otero Ronny M RM   Fowler Vance G VG   Rivers Emanuel P EP   Woods Christopher W CW   Kingsmore Stephen F SF   Kingsmore Stephen F SF  

Science translational medicine 20130701 195


Sepsis is a common cause of death, but outcomes in individual patients are difficult to predict. Elucidating the molecular processes that differ between sepsis patients who survive and those who die may permit more appropriate treatments to be deployed. We examined the clinical features and the plasma metabolome and proteome of patients with and without community-acquired sepsis, upon their arrival at hospital emergency departments and 24 hours later. The metabolomes and proteomes of patients at  ...[more]

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