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[Sepsis merupakan tantangan besar di dunia kedokteran. Terdapat banyakpenelitian yang mencari penanda sepsis yang handal dan soluble Cluster ofDifferentiation-14 subtype (sCD14-ST) mulai banyak diteliti sebagai penandasepsis. Kadar sCD14-ST meningkat secara bermakna di dalam sirkulasi pada faseawal inflamasi dan sepsis. Saat ini belum terdapat data mengenai apakah sCD14-ST dapat digunakan sebagai penanda prognostik sepsis. Tujuan penelitian inidilakukan untuk mengetahui apakah sCD14-ST dapat digunakan sebagai penandaprognostik pada pasien sepsis yang datang di instalasi gawat darurat.Desain penelitian potong lintang, terdiri dari 65 pasien sepsis dibagibedasarkan mortalitas 28 hari, yaitu 37 pasien hidup dan 28 pasien meninggal.Diagnosis sepsis berdasarkan modifikasi definisi sepsis oleh International SepsisDefinitions Conference 2001. Kadar sCD14-ST didapatkan menggunakanpemeriksaan dengan prinsip noncompetitive chemiluminescent enzymeimmunoassay pada alat Pathfast. Pada kedua kelompok tersebut dicatat datakarakteristik subyek dan dilakukan pemeriksaan sCD14-ST.Median kadar sCD14-ST pada pasien hidup adalah 618,00 pg/mL denganrentang 349,50 – 1628 pg/mL dan median kadar sCD14-ST pada pasien yangmeninggal adalah 1287,00 pg/mL dengan rentang 720,75 – 2738,00 pg/mL.Terdapat perbedaan bermakna kadar sCD14-ST pada kedua kelompok dengannilai p 0,005. Ditentukan nilai cut-off sCD14-ST 677,00 pg/mL untuk menentukanprognosis pasien sepsis, dengan AUC 0,706 (IK 95% 0,582 – 0,831), sensitivitas82,1%, dan spesifisitas 54,1%. Kurva Kapplan Meier berdasarkan nilai cut-off677,00 pg/mL menunjukkan gambar yang memenuhi asumsi proporsional hazarddengan rasio hazard 3,794 (IK 95% 1,437 – 10,013), p 0,007.Kami menyimpulkan kadar sCD14-ST pasien sepsis dapat digunakanuntuk memprediksi pasien yang meninggal dilihat dari mortalitas 28 hari, dengannilai AUC sedang. Cut-off kadar sCD14-ST 677,00 pg/mL dapat digunakansebagai cut-off dalam tatalaksana pasien sepsis., Sepsis is a major challenge in the medicine world. Many studies try to findreliable sepsis marker and scientists start to explore soluble Cluster ofDifferentiation-14 subtype (sCD14-ST) as sepsis marker. Concentration ofsCD14-ST significantly increases in circulation on early phase of inflammationand sepsis. Nowadays there is no data whether sCD14-ST can be used asprognostic marker of sepsis. The objective of this study is to investigate theprognostic value of sCD14-ST in sepsis patients presenting at the emergencydepartment.This was a cross-sectional study, from 65 sepsis patient grouped based on28-day mortality, 37 patients are survivors and 28 patients are nonsurvivors.Sepsis diagnosis is made based on modified sepsis definition from InternationalSepsis Definitions Conference 2001. The concentration sCD14-ST was analysedusing Pathfast analyzer with noncompetitive chemiluminescent enzymeimmunoassay test method. Baseline characteristics of subjects were recorded andsCD14-ST concentration were measured in study subjects.Median of sCD14-ST in the survivors group is 618,00 pg.mL with rangeof 349,50 – 1628,00 pg/mL and the median in the nonsurvivors group is 1287,00pg/mL with range of 720,75 – 2738,00 pg/mL. The difference between the twogroups is significant with p 0,005. sCD14-ST cut-off of 677,00 pg/mL is foundwith AUC 0,706 (CI 95% 0,582 – 0,831), sensitivity 82,1%, and specificity54,1%. Kapplan Meier curve based on 677,00 pg/mL cut-off demonstrates thathazard proportion is fulfilled with hazard ratio 3,794 (CI 95% 1,437 – 10,013), p0,007.It is concluded that sCD14-ST concentration in sepsis patients can be usedto predict nonsurvivors based on 28-day mortality, with moderate AUC. Cut-offsCD14-ST of 677,00 pg/mL can be used as cut-off for sepsis patient management.] |
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