Sepsis is a serious medical condition that affects 30 million patients worldwide, leading to 27 million hospitalizations and 6 million deaths per year. Respiratory infections are the most common cause of sepsis. Detecting septic patients early in the emergency department (ED) is crucial. The objective of our study was to analyze the changes in cytokine levels during the first 24 hours in patients who presented with respiratory infections and either developed or did not develop organ dysfunction, which was measured by the SOFA score.

METHODS: Prospective observational cohort of patients with respiratory infections with a high risk of developing sepsis (measured by a NEWS scale >=3). Blood drawn and severity scores were performed at baseline, at 4hs and 24 hs.  Sepsis was defined according to the Sepsis 3 definition. Cytokine time series were modeled using LOESS smoothing.

RESULTS: We analyzed data from 29 patients, of whom 19 developed sepsis within the first 24 hours. There were no significant differences in age or comorbidities between the two groups. None of the cytokine trajectories measured provided an early indication of patients who experienced sepsis, as shown in Figure 1.

Conclusion: In this exploratory analysis, the measures and trajectories of cytokines during the first 24 hours did not allow an early prediction of sepsis in high-risk patients.