Sepsis Score and Acute-Phase Protein Response as Predictors of Outcome in Septic Surgical Patients

Lorenzo Dominioni, Renzo Dionigi, Marco Zanello, Roberto Monico, Riccarda Cremaschi, Roberto Dionigi, Andrea Ballabio, Margherita Massa, Mario Comelli, Paolo Dal Ri, Paolo Pisati

Research output: Contribution to journalArticlepeer-review


• In a series of 135 patients with severe surgical infections, we determined the sepsis score and the plasma level of the acute-phase proteins α-1-acid glycoprotein, α1-antitrypsin, complement factor B, and C3. The initial sepsis score was a strong determinant of survival: in survivors it was significantly lower than in nonsurvivors. Only 8% of patients with a sepsis score above 20 survived. At the onset of severe sepsis, the plasma levels of all four acute-phase proteins were significantly lower in nonsurvivors. A significant elevation of C3a levels in the plasma of both surviving and nonsurviving patients indicated marked consumption of complement components in all patients with severe sepsis. A linear equation was developed to predict survival: sepsis index of survival (SIS) % = 121 + 0.26 (complement factor B) + 0.36 (α-1-acid glycoprotein) – 6 (sepsis score). Based on our analysis, at the onset of severe sepsis, an SIS of 50% or more can correctly predict 88% of survivors and an SIS less than 50% can correctly predict 86% of nonsurvivors several days in advance of clinical outcome.

Original languageEnglish
Pages (from-to)141-146
Number of pages6
JournalArchives of Surgery
Issue number2
Publication statusPublished - 1987

ASJC Scopus subject areas

  • Surgery


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