First Signs at Admission: Prognostic Value of Initial Proinflammatory Markers for Sepsis and Mortality in ICU Patients

Sepsis is a life-threatening condition and due to its non-specific symptoms, diagnosing sepsis and determining its severity remains difficult. Delays in recognizing sepsis can significantly increase mortality despite advances in antimicrobial therapy and resuscitation procedures. Biomarkers can help detect the presence and severity of sepsis, distinguish between types of infections, and evaluate treatment response. This prospective study aims to determine whether biomarker levels measured at the time of intensive care unit (ICU) admission can assist in the early prediction, diagnosis, and prognosis of sepsis and bacteremia. Blood samples were collected from 132 ICU patients upon admission and analyzed for CRP, IL-6, PCT, SAA, and endotoxin levels. Patients were monitored for sepsis development, blood culture results, and mortality. IL-6 levels demonstrated a significant association with prognosis and identified as an independent risk factor. CRP and PCT levels exhibit a significant effect on the development of sepsis in both univariate and multivariate analyses. Also, our study demonstrated that the presence of bacteremia in the initial blood sample taken from intensive care patients holds significant diagnostic and prognostic value even without waiting for species-level identification when combined with markers such as PCT, CRP, and IL-6.