Biomarkers as Predictors of Mortality in Ventilator-Associated Pneumonia and Sepsis: A Comprehensive Analysis

Abstract

Two serious medical conditions named sepsis and ventilator associated pneumonia affect mechanically ventilated patients through high rates of both severe illness and death. This retrospective cohort study evaluated sepsis and VAP predictive biomarkers through the assessment of procalcitonin (PCT), C-reactive protein (CRP) and mean platelet volume (MPV) together with neutrophil to lymphocyte count ratio (NLCR) combined with Sequential Organ Failure Assessment (SOFA) score. The study investigated both the microbial distribution of Gram negative and Gram-positive agents combined with VAP the sepsis cases. The study enrolled 119 sepsis patients with 63 (52.94%) cases of VAP among them while 56 patients (47.05%) had no VAP development. The study investigated pathogen frequency and biomarker quantities through microbiological analysis and employed SOFA scoring on days 0 and 3. The results demonstrated that the SOFA score delivered the best forecasting performance (AUC = 0.860, p < 0.001) regarding VAP occurrence and 28-day mortality (OR = 1.536, p < 0.001) while PCT, CRP, MPV, and NLCR proved inadequate to predict VAP occurrence or mortality. The primary microbial agents in VAP associated sepsis were Gram negative germs including Pseudomonas aeruginosa, Escherichia coli and Acinetobacter baumannii while Gram positive pathogens included Staphylococcus aureus and Enterococcus species. Research data indicates that the SOFA score plays an essential role in assessing patient risk while also supporting specific antimicrobial drug selection based on detected microbial agents. Finally, this study demonstrates the importance of SOFA score in prediction of VAP and mortality in sepsis patients, whereas traditional biomarkers were not useful. The role of pathogens in VAP-associated sepsis is highlighted by their contribution to microbiological analysis. However, clinical scoring systems and microbial data can be integrated into routine practice to more effectively improve outcomes in sepsis and VAP ICU critically ill patients