High-density lipoprotein 2b combined with sequential organ failure assessment score as a novel prognostic indicator for sepsis patients: a prospective study.

BACKGROUND: Sepsis is a state of life-threatening organ dysfunction caused by a dysregulated host response to infection, leading to consecutive organ failure and lethal outcome. The purpose of this study is to assess the value of the combined use of plasma high-density lipoprotein 2b (HDL2b) level and Sequential Organ Failure Assessment (SOFA) score in predicting short-term mortality from sepsis. MATERIALS AND METHODS: A prospective, observational study was conducted in patients with sepsis and non-septic controls admitted to three intensive care units (ICUs) from January 2020 to December 2021. SOFA scores were recorded on the first day after admission. Blood samples were collected from each enrolled patient and the levels of HDL2b were analyzed using microfluidic chip technology. Receiver-operator characteristic curve (ROC) analyses were conducted to determine the values of plasma HDL2b level, SOFA score and the combined HDL2b levels and SOFA score (HDL2b + SOFA) in predicting the prognosis of mortality, respectively. The primary endpoint was 28-day mortality and the secondary outcome was total in-hospital mortality. RESULTS: Compared to non-septic controls, patients with sepsis had lower HDL2b levels (10.95% [8.95, 12.96] vs. 23.78% [14.53, 29.16], p < 0.001). Among sepsis patients, the levels of HDL2b of non-survivors were lower than those of survivors (6.74% [4.63, 8.08] vs. 11.78 [7.20, 13.40], p = 0.002). Moreover, our data also indicated that patients with higher HDL2b + SOFA scores shown higher rates of 28-day and total in-hospital mortality. The areas under the ROC curves for predicting 28-day mortality were 0.755 for HDL2b, 0.782 for SOFA, and 0.806 for HDL2b + SOFA. Multivariate analyses indicated that HDL2b + SOFA (Odd Ratio: 1.321 (95% Confidence Interval: 1.028-1.698), p = 0.029) was potential predictors of 28-day mortality. CONCLUSIONS: The HDL2b + SOFA composite score was a reliable predictor of 28-day and in-hospital mortality in sepsis patients, showing better discriminatory ability than SOFA alone.