ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1538515
This article is part of the Research TopicMolecular mechanisms and clinical studies of multi-organ dysfunction in sepsis associated with pathogenic microbial infectionView all 14 articles
Enhancing Sepsis Management: The Role of Dynamic Heparin-Binding Protein Monitoring in Elderly Patients
Provisionally accepted
- Second People's Hospital of Lianyungang, Lianyungang, China
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Background: Sepsis is a life-threatening condition with particularly high mortality rates among the elderly. This study investigates the dynamic monitoring of heparin-binding protein (HBP) levels as prognostic biomarkers to improve risk stratification and management in elderly septic patients.Methods: We conducted a retrospective cohort study involving patients aged 65 and older who were hospitalized for sepsis. Data were extracted from electronic medical records, including demographic, clinical, and laboratory information. We analyzed the relationship between dynamic HBP levels and 28-day mortality using linear mixed-effects models to assess the effects of time and prognostic groups.Results: Among 386 elderly septic patients, the 28-day mortality rate was 20.73%. HBP levels were significantly elevated at all time points in the mortality group compared to the survival group (p < 0.001). The linear mixed-effects model indicated that time, prognosis group, and their interaction significantly influenced HBP levels. In the survival group, HBP levels decreased significantly over time, whereas the mortality group exhibited a smaller reduction, with HBP levels remaining elevated overall. The prognostic predictive ability of HBP improved at various time points, with the combined model of HBP and C-reactive protein (CRP) showing time-varying area under the curve (AUC) values: 0.728 on day 10, 0.744 on day 15, and 0.803 on day 20. The time-dependent ROC curve demonstrated that the combined model consistently exhibited superior discriminative ability throughout the follow-up period. Additionally, the time-dependent Cox regression model indicated that dynamic HBP levels effectively predicted 28-day mortality risk across all subgroups (p < 0.001).Conclusion: Dynamic monitoring of HBP levels may aid in risk stratification and support clinical decision-making. Further prospective studies are required to evaluate its clinical utility and potential impact on patient management.
Keywords: Elderly, Sepsis, heparin-binding protein, dynamic monitoring, prognosis
Received: 02 Dec 2024; Accepted: 27 May 2025.
Copyright: © 2025 Miao, Liu, Liao, Shen, Xie and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jingxian Liao, Second People's Hospital of Lianyungang, Lianyungang, China
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