Compare Serum VCAM-1, NSE, Procalcitonin in Predict Sepsis Induced Encephalopathy in Septic Patients.

BACKGROUND: Sepsis-associated encephalopathy (SAE) is a common complication of severe sepsis. Increased concentration of Vascular Cell Adhesion Molecule 1 (VCAM-1) is associated with SAE in a previous study. Neuron-specific enolase (NSE) was shown to be related to brain injury in cardiac arrest and trauma patients and procalcitonin was associated with the severity of sepsis. But their relationship with sepsis-associated encephalopathy was unknown. OBJECTIVE: This study aimed to compare VCAM-1 with NSE and procalcitonin in association with sepsis-associated encephalopathy. METHODS: Fifty-nine adult patients with sepsis admitted through the emergency department were evaluated. VCAM-1, NSE, and procalcitonin were assessed for their relationship with SE and compared with other clinical predictors and biomarkers. RESULTS: 29 (49%) patients had SAE. SAE group had higher VCAM-1 (1891.9 [1513.3-3229.9] vs. 1562.3 [1034.9-1892.9]), and lactate levels (32.1 [17.5-53.9] vs. 15 [10.3-24]) on admission than the non-SAE group. NSE and procalcitonin were not statistically significantly associated with sepsis-associated encephalopathy. Serum VCAM-1 is associated with procalcitonin (ρ = 0.433, p < 0.01) but not NSE (ρ = -0.208, p = 0.114). Serum VCAM-1 level can be used to predict sepsis-associated encephalopathy on Day 1, Day 4, Day 7 of sepsis. The AUC analysis of the ROC curve of serum sVCAM-1 showed that Day 7 had a higher AUC 0.856 (0.746-0.966) than Day 4 (0.802 [0.674-0.929]) and Day 1 (0.711 [0.563-0.859]). CONCLUSION: Serum VCAM-1 serves as a significant predictor of sepsis-associated encephalopathy as defined in this study within the first seven days of sepsis identification. In contrast, NSE and procalcitonin did not demonstrate statistically significant associations with sepsis-induced encephalopathy in this study.