Predictive Value of Thiol–Disulfide Homeostasis and Ischemia-Modified Albumin on Survival in Patients with Sepsis

Abstract

Objective: Sepsis is a dysregulated systemic inflammatory and oxidative response to infection. Thiol–disulfide homeostasis (TDH) has a crucial role in the protection from oxidative stress and is a reliable indicator of oxidative stress. Furthermore, ischemia-modified albumin (IMA) is an indicator of oxidative-stress-related tissue damage. In this study, we determined the predictive value of TDH and IMA on 28-day mortality in patients undergoing sepsis. Materials and Methods: We collected blood samples from adult patients undergoing sepsis at the time of admission to the intensive care unit to determine TDH and IMA levels. Concurrently, we calculated Sequential Organ Failure Assessment (SOFA) scores to weigh the severity of sepsis. Moreover, we followed up the patients for 28-day intra-hospital mortality. We statistically analyzed the study parameters of the patients in both the survivor and non-survivor groups. Results: Forty-six patients with sepsis were enrolled. Among them, 27 survived at the end of the 28-day follow-up period. The mean age of the patients was 73.07+-13.87 years, and 43.5% of them were female. The mean SOFA score was significantly higher in the non-survivor group (p<0.05). However, no significant differences in the total thiol, native thiol, disulfide, and IMA levels at baseline were observed between the survivor and non-survivor groups (p>0.05 for all). Receiver operator characteristics (ROC) and area under the curve (AUC) analysis revealed that IMA and thiol parameters had no predictive power on the survival of patients with sepsis. Conclusion: This study showed that baseline TDH parameters and IMA levels were not significantly different between survivors and non-survivors of sepsis and were not related to the prediction of mortality.

Keywords

• sepsis
• oxidative stress
• protein disulfide reductase
• survival
• mortality