The Biomarker Prediction Model of Septic Risk in Infected Patients

October 14, 2021 updated by: Beijing Tsinghua Chang Gung Hospital

The Biomarker Prediction Model of Septic Risk in Infected Patients: Observational Multi-center Study

Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to an infection. Sepsis is associated with high mortality because of the complex mechanisms. In China, the mortality of sepsis in ICU was up to 35.5%. As a major and urgent global public health challenge，sepsis is hard to treat because of the complexion and highly heterogeneous in clinical manifestation. The early diagnosis and stratification of the infection is very important. If we can identify the patients who may developed into the sepsis, the therapeutic regimen was not only antibiotic, but also included stable the vascular endothelial cells，regulation of coagulation function and protection of organ functions. Biomarkers have an important place in sepsis because they are strictly related to the organ damage. Each organ has its own specific biomarkers, and these biomarkers will change according to the severity of the disease. So the investigators want to find the difference of biomarkers of each organ in patients from infection to spesis.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Active, not recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Detailed Description

According to the definition, infection is the original source of sepsis. How can diagnose organ failure early is the most impotent thing which can prevention the sepsis. In 2021, the guidelines for management of septic and septic shock recommend Sequential Organ Failure Assessment (SOFA) and systemic inflammatory response syndrome (SIRS) to diagnose sepsis. The standards of SOFA were acquired from clinical manifestations，such as blood pressure, oxygenation index, platelet, etc. These indexes can abnormal at the end of organ failure. On the other hand, it is difficult to acquire these indexes in emergency. There is wide variation in diagnostic accuracy of these tools with most having poor predictive values.

The number of publications related to sepsis biomarkers has increased over the years. The proportion of new biomarkers has decreased. Because of the complexity of the sepsis response, single biomarker might be fruitless. The investigators want to use the cytokines which have found and can represent the function of the organ in septic patients. The investigations can use these biomarkers of respiratory system, circulation, liver, renal system, coagulation and nervous system, to build up a prediction model of septic risk in infected patients.

The participants will be divided into "training set" and "verification set" randomly. The proportion of training set: verification set is 3:2. In the training set, the investigators will compare the cytokines between infection and sepsis. In sepsis patients, the investigators will compare the data between "organ failure group" and "control group", and use these data to build up the prediction model of septic risk. These data will be verify the validity and accuracy of the model in the verification set.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Anticipated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
1000

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
    • Beijing
      • Beijing, Beijing, China, 102218
        • Tsinghua Changgung Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

patients who visit the emergency of the research center hospital

Description

Inclusion Criteria:

  • Patients who meet any of the diagnostic criteria of "suspected infection", "confirmed infection" and "suspected sepsis".

Exclusion Criteria:

  • age < 18 years old; pregnancy or breast-feeding; lack of informed consent by the patients or relatives.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
control
the infection patients who didn't have organ failure according to the SOFA score: 1. respiratory system: PaO2/FiO2≥<400 mmHg; 2. MAP≥70mmHg; 3. Liver: Bilirubin<1.2mg/dL; 4. Renal system: Creatinine<1.2mg/dL or Urine output≥500ml/d; 5. Platelets≥150×10^9/L; 6. nervous system:Glasgow coma score=15.
organ failure
the patients who had sepsis in follow up period: 1. respiratory system:PaO2/FiO2<400mmHg; 2. Circulation: MAP<70mmHg or administration of vasopressors required; 3. Liver: Bilirubin≥1.2mg/dL; 4. Renal system: Creatinine≥1.2mg/dL or Urine output<500ml/d; 5. Coagulation: Platelets<150×10^9/L; 6. nervous system: Glasgow coma score <15.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
the change of biomarkers between the septic patients with and without ARDS
Time Frame: Participant will be followed up to 14 days to observe whether they can be diagnosed sepsis or not.
endocan (the cutoff value is 2.45 ng/ml to diagnose ARDS); sydecan-1 and Ang 2 are also the biomarkers of ARDS, they can but the cutoff values are not certain.
Participant will be followed up to 14 days to observe whether they can be diagnosed sepsis or not.
the change of biomarkers between the septic patients with and without disturbance of consciousness
Time Frame: Participant will be followed up to 14 days to observe whether they can be diagnosed sepsis or not.
neuron-specific enolase (NSE), the cutoff value is 24.15 ng/ml to diagnose Septic encephalopathy; S100β: is a calcium-binding protein released by brain astrocytes. The increase of S100β is represents breakdown of the blood-brain barrier.
Participant will be followed up to 14 days to observe whether they can be diagnosed sepsis or not.
the change of biomarkers between the septic patients with and without abnormal coagulation function
Time Frame: Participant will be followed up to 14 days to observe whether they can be diagnosed sepsis or not.
tissue factor (TF): as the important components of exogenous coagulation pathways, TF will be elevated in sepsis. the cutoff value is 1005.8 pg/ml.
Participant will be followed up to 14 days to observe whether they can be diagnosed sepsis or not.
the change of biomarkers between the septic patients with and without circulatory failure
Time Frame: Participant will be followed up to 14 days to observe whether they can be diagnosed sepsis or not.
heart type fatty acid-binding protein (hFABP): The expression was increased in patients with septic myocardial injury, with intercept value ≥4.5 ng/mL, sensitivity of 83%, specificity of 73%. The myocardial enzyme will also be tested.
Participant will be followed up to 14 days to observe whether they can be diagnosed sepsis or not.
the change of biomarkers between the septic patients with and without acute kidney failure
Time Frame: Participant will be followed up to 14 days to observe whether they can be diagnosed sepsis or not.
neutrophil gelatinase-associated apolipoprotein (NGAL) and serial serum cell adhesion molecules (the cutoff value is 124.4 ng/ml)
Participant will be followed up to 14 days to observe whether they can be diagnosed sepsis or not.
the change of biomarkers between the septic patients with and without liver failure
Time Frame: Participant will be followed up to 14 days to observe whether they can be diagnosed sepsis or not.
Golgi body 73 (GP73): is rarely or not expressed in normal liver cells, but is relatively stable in bile duct epithelial cells of the liver. When liver lesions occur, the expression level of GP73 is significantly higher. endothelin-1 is another biomarker to evaluate the liver function in sepsis
Participant will be followed up to 14 days to observe whether they can be diagnosed sepsis or not.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Beijing Tsinghua Chang Gung Hospital

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Peking Union Medical College Hospital
Tianjin Medical University General Hospital
Renmin Hospital of Wuhan University
Hebei Medical University Third Hospital
First Hospital of Tsinghua University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Chair: Wang zhong, master, Beijing Tsinghua Chang Gung Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 7, 2021

Primary Completion (ANTICIPATED)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
September 7, 2022

Study Completion (ANTICIPATED)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 14, 2022

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
September 23, 2021

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 14, 2021

First Posted (ACTUAL)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
October 27, 2021

Study Record Updates

Last Update Posted (ACTUAL)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
October 27, 2021

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 14, 2021

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2021

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 20210520

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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