Serum inflammatory biomarkers can predict clinical outcomes in patients with sepsis-associated gastrointestinal dysfunction

Abstract

BACKGROUND

Effective predictive indicators for clinical outcomes in septic patients with gastrointestinal dysfunction (GID) remain lacking.

AIM

To evaluate the relationship between serum inflammatory biomarkers (SIBs) and clinical outcomes in patients with sepsis-induced GID.

METHODS

A total of 117 sepsis-induced GID patients were selected (January 2021 to January 2025). They were grouped into poor [n = 76; Acute Physiology and Chronic Health Evaluation II (APACHE II) score > 10] and good (n = 41; APACHE II ≤ 10) prognosis groups based on outcomes. Clinical variables (sex, age, body mass index, smoking history, diabetes, hypertension, and infection site) were collected. SIBs, encompassing procalcitonin (PCT), C-reactive protein (CRP), interleukin (IL)-6/10, and tumor necrosis factor (TNF)-α, were analyzed. Correlation analyses were conducted to assess the associations of SIBs with Sequential Organ Failure Assessment (SOFA) and APACHE II scores. Receiver operating characteristic curves visualized SIBs’ predictive performance, and multivariate analysis identified independent outcome predictors.

RESULTS

The groups were similar in age, sex, body mass index, comorbidities, and major infection site. The poor prognosis group exhibited elevated APACHE II, SOFA, PCT, CRP, IL-6, IL-10, and TNF-α than the good prognosis cohort. SIBs correlated positively with both APACHE II and SOFA scores. When used to predict outcomes individually, SIBs yielded an area under the curve range of 0.660-0.780 in septic patients with GID, whereas combined biomarker analysis increased the area under the curve to 0.906. APACHE II, SOFA, PCT, CRP, IL-6, and TNF-α acted as independent predictors of prognosis.

CONCLUSION

SIBs correlate intimately with clinical outcomes in sepsis-induced GID patients.

Keywords: Serum inflammatory biomarkers; Procalcitonin; C-reactive protein; Interleukin-6/10; Sepsis; Gastrointestinal dysfunction; Clinical outcome; Predictive value

Core Tip: This study analyzed 117 patients with sepsis-associated gastrointestinal dysfunction and identified procalcitonin, C-reactive protein, tumor necrosis factor-alpha, and interleukin-6/10 as key biomarkers of disease severity and prognosis. Elevated C-reactive protein and tumor necrosis factor-alpha levels and higher Sequential Organ Failure Assessment scores increased the likelihood of poor outcomes, while combining multiple biomarkers significantly improved predictive accuracy.