ESM-1 Levels and ARDS Prediction Score for Predicting ARDS Occurrence in Sepsis Patients

Abstract Background: Acute respiratory distress syndrome (ARDS) development is overtly associated with elevated mortality. This study aimed to determine the parameters predicting ARDS in sepsis patients. Methods: This was a retrospective case control study. The sepsis patients admitted to the intensive care unit were divided into the ARDS and non-ARDS groups according to ARDS occurrence within 72 hours. Plasma endothelial cell specific molecule-1 (ESM-1), white blood cell (WBC), C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT) were assessed on the first day. PaO2/FiO2 ratio was determined on the first two days. Pearson correlation analysis and logistic regression analysis were carried out. Results: The ARDS and non-ARDS groups included 12 and 42 patients respectively. ESM-1 levels in the ARDS group on the first day were significantly lower than those of the non-ARDS group (P=0.009). ESM-1 levels and PaO2/FiO2 ratio were positively correlated. Logistic regression analysis showed that ESM-1, CRP and IL-6 levels on the first day were associated with ARDS. The areas under the receiver operating characteristic curve (ROC) curves (AUCs) for ESM-1, CRP and IL-6 were 0.750, 0.736 and 0.736, respectively. A regression equation was established based on the coefficients of plasma ESM-1, CRP and IL-6 levels to derive an ARDS prediction score with an AUC for predicting ARDS of 0.895.Conclusion: Plasma ESM-1, CRP and IL-6 levels on the first day are associated with ARDS in sepsis. The novel ARDS predictive score is obviously better than ESM-1, CRP and IL-6 in predicting ARDS in sepsis patients.