Assessment of the Diagnostic and Prognostic Value of the Serum Netrin-1 Level in Patients Presenting the Emergency Department with Sepsis

Abstract

Aim: Sepsis affects approximately 50 million people across the world each year and causes 11 million deaths. Many biomarkers have been investigated for the early diagnosis of sepsis and patient responses to infection and treatment, as well as to help clinicians predict risk and plan treatment. Netrin-1 plays an important role by directing the migration of neutrophils, particularly monocytes, in inflamed tissue. This study aimed to determine whether Netrin-1 was an effective marker in the diagnosis, treatment follow-up, and prognosis evaluation of patients with sepsis and septic shock. Material and Method: This observational and prospective study was conducted at the emergency department with 121 individuals over 18, including 71 patients diagnosed with sepsis and 50 healthy volunteers. The patients were further evaluated in two subgroups: sepsis and septic shock. Blood samples were taken from the patient and control groups at the time of presentation and on the third day. Netrin-1 levels were examined in both groups. Results: The netrin-1 levels of the patients with sepsis and septic shock upon presentation to the hospital were significantly higher than the control group (p<0.0001). However, there was no significant difference between the netrin-1 levels measured at the time of presentation and on the third day in the sepsis and septic shock groups (p: 0.0522 and 0.0786, respectively). Neither the presentation nor the third-day netrin-1 level had a statistically significant correlation with mortality (p=0.075 and 0.254, respectively). Conclusion: Our results showed that netrin-1 was an effective biomarker for diagnosing sepsis and septic shock. However, it was not a risk factor for mortality or clinical risk scores in patients with these conditions.

Keywords

• netrin-1
• sepsis
• emergency department

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