The mortality prognostic value of plasma angiopoietin-2 levels in patients with sepsis

Introduction: To evaluate the prognostic value of plasma Angiopoietin-2 (Ang-2) levels for mortality in patients with sepsis. Material and methods: A prospective, descriptive, longitudinal study was conducted on 68 sepsis patients treated at the ICU of Military Hospital 103 from September 2018 to October 2020. Data were collected at two-time points: at sepsis diagnosis (D0) and 3 days post-diagnosis (D3). Results: Plasma Ang-2 levels at D0 and D3, and the Ang2/1 ratio at D3 were significantly higher in the mortality group compared to the survival group (p < 0.05). Each 1 pg/mL increase in plasma Ang-2 at D0 and D3 raised mortality risk by 1.003 and 1.004 times, respectively (p = 0.000). Multivariate analysis identified Ang-2-D3 and APACHE II-D3 as independent prognostic factors for mortality (p < 0.05). The prognostic value of Ang-2-D3 was good (AUC = 0.83). Patients requiring antibiotic regimen changes (based on culture and sensitivity results) due to clinical non-response were significantly more common in those with increased Ang-2-D3 compared to those without changes (65% vs 25%, p = 0.002). The proportion of patients requiring a change in the antibiotic regimen (based on culture and sensitivity results) due to an inadequate clinical response to the initial therapy was significantly higher in patients exhibiting a substantial increase in Ang-2-D3 (compared to Ang-2-D0) (65% vs 25%, p = 0.002) Conclusions: Plasma Ang-2 levels at day 3 post-sepsis diagnosis are an independent prognostic marker for mortality in sepsis patients, with good predictive accuracy (AUC = 0.83). Consider changing antibiotics if the Ang-2 level on the third day after sepsis diagnosis increases compared to its level at the time of diagnosis.