Association of cysteine-rich protein-61 molecule with organ failure in patients with sepsis or septic shock

Introduction: Sepsis is defined as a medical emergency that causes the body's abnormal and inappropriate host response to infection, resulting in life-threatening organ dysfunction. Epidemiological studies show that Sepsis affects more than 30 million people worldwide every year, additionally, causes 60% of mortality in intensive care patients and is the one of the leading causes of death in intensive care units. There are some studies on biomarkers to predict which patients may develop organ failure and to reduce mortality. With this prospective study, it has been aimed to determine whether it would be a prognostic biomarker in indicating organ failure in patients with sepsis or septic shock. Method: This study has been conducted with the prospective analysis of 80 patients hospitalized with the diagnosis of sepsis or septic shock in the intensive care unit of Çukurova University, Faculty of Medicine, Major Science of Internal Medicine, Intensive Care Unit, and the intensive care unit of the Major Science of Anesthesiology Reanimation between January and November, 2022. The diagnosis of sepsis or septic shock has been established in accordance with the SOFA score and the criteria in the new sepsis guideline published in 2021. Demographic information, vital sciences, organ failure scoring, biochemical and microbiological parameters, 7th and 28th day mortality results of the patients have been evaluated. Results: The total number of patients in within this study is eighty. In this study, no significant difference has been found in the section where the relationship between sepsis and septic shock and organ failure of the Cyr-61 protein has been examined. Additionally, there has been no statistically significant difference between the measurement of Cyr-61 protein of the patients and the results of those with and without mortality on the 7th and 28th days. The 7th and 28th day mortalities of the patients have been found to be 37.5% and 62.5%, respectively. The correlation between the 48th hour measurement of the patients' Cyr-61 protein and anuria has been found to be statistically significant (p=0.029). When we look at the levels between the hours, the 0th hour measurement of Cyr-61 is statistically significantly lower than the measurement values of the other hours; Cyr-61 measurement at 24 and 48 hours has been found to be statistically significantly higher (p=0.0001). When the correlation between the measurement of Cyr-61 levels at all hours (0.-24. and 48. hours) and infection findings has been examined, it has been found that the mixed infection site is statistically significant (p=0.041; p=0.013; p=0.036, respectively). Conclusion: A statistically significant correlation has been found between the 48th hour measurement of Cyr-61 protein and anuria. This suggests a promising result that the Cyr-61 protein may be associated with organ failure and could be used as a prognostic biomarker in sepsis in the future. It is needed to be evaluated with large studies such as 90-day mortality instead of 7th and 28th day mortality. Key words: Sepsis; Septic Shock; Organ Failure; Cysteine Rich Protein-61 (Cyr-61, CCN1)