Predictive value of oxidative stress, inflammatory markers and prognostic nutritional index (thiol-disulfite, ischemia modified albumin) for sepsis mortality

Introduction: In this thesis study, oxidative stress markers(thiol disulfide, ischemia-modified albumin), inflammatory markers and the predictive value of the prognostic nutrition index were examined for sepsis mortality. Sepsis is a systemic inflammatory response syndrome caused by a serious infection. High mortality rates are observed as a result of this syndrome. Oxidative stress, on the other hand, is associated with the accumulation of free radicals that cause cellular damage. Oxidative stress biomarkers such as thiol disulfide and ischemia-modified albumin can reflect the oxidative stress levels of patients. In addition, inflammatory markers may also reflect the severity of inflammation in the sepsis process. The prognostic nutrition index is a criterion that reflects the nutritional status and general health of the patient. Objective: In this study, it is aimed to determine the ability of the indicated biomarkers and the prognostic nutrition index to predict the mortality risk of sepsis patients. The sample of the study consists of patients admitted to the Emergency Department of Bolu Abant Izzet Baysal University Education and Research Hospital with suspected infection. Materials and Methods: Qualitative method was used in the study. First of all, thiol-diphulfite, ischemia-modified albumin values, hemogram and biochemical inflammatory markers of patients diagnosed with sepsis with sepsis -3 criteria were examined. Then, the prognostic nutrition index showing the nutritional status was calculated and the results obtained were analyzed with the help of the SPSS program. Results: The average age of the 74 cases examined within the scope of the study was 77.20±11.05. 89.04% (n=65) of the patients were admitted, 8.22% (n=6) were discharged, and 2.74% (n=2) were referred. In the study, the median QSOFA value of the patients was determined as 2, the median SOFA value was determined as 6, the average APACHE 2 score was determined as 23.65±5.75, and the median PNI value was determined as 35.1. The laboratory values of the patients participating in the study were evaluated statistically. The IMA Abs median was calculated as 0.62 AU, TTL mean was 356.8±131.94 µmol/L, NTL median was 272 µmol/L, disulfide median was 36 µmol/L, SS/SH median was 11.185, disulfide/TTL mean was 0.10±0.04, NTL/TTL mean was 0.80±0.08. It was determined that 39.19% (n=29) of the patients had ex within one month and 51.35% (n=38) of the patients had ex within two months. Conclusion: The findings obtained have a potential value in the management of sepsis patients, supporting clinical decision-making processes and predicting the survival of sepsis patients. The thesis of the study is that biomarkers and the prognostic nutrition index are also highly functional in predicting the mortality risk of sepsis patients.