To investigate this, Cox logistic regression analysis was performed. In the equation, advent of death was set as the dependent variable. Two universally accepted conditions affecting final outcome ? namely, the presence of severe sepsis/shock and the presence of at least one underlying disease ? were also taken into consideration to try to decipher whether APACHE II score and suPAR may independently www.selleckchem.com/products/3-deazaneplanocin-a-dznep.html prognosticate for unfavorable outcome under the influence of these conditions. Analysis was done in a forward step-wise manner, and results are shown in Table Table1.1. According to this analysis, serum suPAR of at least 12 ng/mL and APACHE II score of at least 17 retained an independent link with unfavorable outcome even when superimposed over the presence of severe sepsis/shock and the presence of underlying diseases.

As a consequence, these two cutoffs may be safely used to build a prognostication rule for the assessment of unfavorable outcome in sepsis.Table 1Step-wise Cox regression analysis of factors related to unfavorable outcome in the study cohort of 1,914 Greek patientsIt was then clearly defined that, among patients with an APACHE II score of less than 17 and among patients with an APACHE II score of at least 17, suPAR could significantly indicate those with high risk for death (Table (Table2).2). More precisely, OR for death with suPAR of at least 12 ng/mL among patients with an APACHE II score of less than 17 was 3.62; OR was 1.79 with suPAR of at least 12 ng/mL among patients with an APACHE II score of at least 17. The calculated ORs were significantly different (P of comparisons = 0.

006 by the Breslow-Day test and P = 0.007 by the Tarone test), indicating that APACHE II score and suPAR were independent prognosticators of unfavorable outcome and should both be used in a prediction model.Table 2Validation of the new stratification schemePrognostication ruleWith the above cutoff values, four strata of sepsis severity were defined: (i) patients with an APACHE II score of less than 17 and a serum suPAR of less than 12 ng/mL, (ii) patients with an APACHE II score of less than 17 and a serum suPAR of at least 12 ng/mL, (iii) patients with an APACHE II score of at least 17 and a serum suPAR of less than 12 ng/mL, and (iv) patients with an APACHE II score of at least 17 and a serum suPAR of at least 12 ng/mL; 893, 334, 293, and 394 patients ended up in each stratum and had respective mortality rates of 5.

5% (n = 49), 17.4% (n = 58), 37.4% (n = 109), and 51.5% (n = 203) (P < 0.0001 within the four defined strata; Figure Figure44).Figure 4Kaplan-Meier estimates of survival of patients enrolled in the study cohort stratified into four strata of severity by APACHE II score Cilengitide and serum suPAR. Every curve differed significantly from the others. Log-rank tests of comparisons are stratum (i) versus …