الفهرس 
List of ContentsOnly 14 pages are availabe for public view
 |  | from | 109 |  |  |
| | | from | 109 | | |
Abstract
Our aim is was to assess level of sEPCR in septic ICU patients upon admission and after sepsis treatment to ensure whether it can be used as a marker of sepsis or not and as prognostic marker for sepsis severity or not. The study was conducted on 42 subjects,16 healthy control and 26 ICU sepsis patients. All septic ICU patients were subjected to full clinical history and examination, (SOFA) score assessment and laboratory investigations as CBC, CRP, aerobic and anaerobic blood culture, aerobic and anaerobic culture from any septic site in the body, liver function test, serum creatinine, INR and lactate level and ELISA assay for soluble EPCR. Samples were collected from patients within 24 h of their admission after meeting the criteria of sepsis, another two samples after one week and two weeks of start of treatment of sepsis. • Results of the current study were Regarding sEPCR level, it was significantly elevated in sepsis patients than control group(p<0.001). ROC analysis was conducted to identify the optimal sEPCR levels for prediction of sepsis. EPCR score best cut-off values were 27.55. The area under the curve (AUC) was 0.950 (p=<0.001). sEPCR was significantly increased in second and third measurement compared to basal in contrast to SOFA score which showed no significant could be detected. There is significant elevation sEPCR of second and third measurement in non survivors patients compared to survivors. Regarding hematological and hemostatic data, there was significant reduction of Hb, PLT and in septic patients compared to control(p<0.001). In addition, WBCS and INR were significantly elevated in patients compared to control group(p<0.001). Regarding chemical parameters, threre was significant reduction of albumin in septic patients compared to control group(<0.001). Moreover, lactate level was significantly elevated in septic patients than control group(p<0.001). Regarding serial measurements of some lab, hematological and hemostatic data within cases, Hb was significantly decreased in third measurement (p<0.001) compared to basal. CRP and lactate were significantly increased in third measurement (p=0.001), (p=0.04) repectively. There is significant reduction of PLT in non survivors patients compared to survivors. Also, CRP was significantly elevated non survivors patients compared to survivors. sEPCR was significantly unique independent risk factor for sepsis using logistic regression analysis. Conclusion was that Level of sEPCR is significantly elevated in sepsis patients than healthy cotrol which means it can be used as diagnostic marker of sepsis and Level of sEPCR is significantly higher in non survivors than survivors indicating that it can be used as prognostic factor for sepsis outcome.