OBJECTIVE: To evaluate prognostic value of pentraxin3 ( PTX3 ) content combining 
with extravascular lung water index ( EVLWI ) in patients with sepsis.
METHODS: A retrospective analysis of complete clinical data of septic patients 
admitted to Department of Critical Care Medicine of the First Affiliated 
Hospital of Zhengzhou University from February 2013 to February 2014 was 
conducted. These patients were divided into two groups, survival group and death 
group, according to the outcome on the 28th day. Pulse index continuous cardiac 
output ( PiCCO ) was used to record the levels of EVLWI on the 1st, 2nd and 3rd 
day of intensive care unit ( ICU ) admission. The plasma level of PTX3 was 
measured simultaneously by enzyme-linked immunosorbent assay ( ELISA ). At the 
same time, acute physiology and chronic health evaluation II ( APACHEII) score 
and sequential organ failure assessment ( SOFA ) were calculated. Correlation 
analysis between plasma PTX3 and EVLWI values was performed, receiver operating 
characteristic curve ( ROC ) was drawn, and the prognostic value of each 
parameter was assessed finally.
RESULTS: A total of 74 septic patients were enrolled, with 41 cases in the 
survival group and 33 cases in the non-survival group. Blood lactate, APACHEII, 
SOFA scores in the non-survival group were significantly higher than those of 
the survival group at ICU admission, and the length of ICU stay was 
significantly shorter than that of the survival group, while differences of the 
other clinical characteristics between two groups were not statistically 
significant. The plasma PTX3 level gradually declined with time in both groups, 
and plasma PTX3 at 1, 2, 3 days after ICU admission in non-survival group were 
significantly higher than those in survival group [ PTX3 ( μg/L ) at 1 day: 
46.3±10.5 vs. 19.4±6.5, t = -13.486, P = 0.000; 2 days: 34.8±10.7 vs. 17.7±8.4, 
t = -8.284, P = 0.000; 3 days: 23.9±11.2 vs. 15.6±7.9, t = -5.036, P = 0.000 ]. 
EVLWI gradually declined in survival group, but increased in death group. EVLWI 
at 1, 2, 3 days after ICU admission in non-survival group were significantly 
higher than those in survival group [ EVLWI ( mL/kg ) at 1 day: 12.12±4.31 vs. 
10.02±2.87, t = -2.502, P = 0.023; 2 days: 13.67±4.95 vs. 9.08±2.89, t = -5.188, 
P = 0.000; 3 days: 14.51±5.06 vs. 8.09±2.50, t = -7.126, P = 0.000 ]. PTX3 at 1, 
2, 3 days after ICU admission showed a significant positive correlation with 
EVLWI ( r1 = 0.747, r2 = 0.719, r3 = 0.705, all P = 0.000 ). ROC curve analysis 
showed that the area under the ROC ( AUC ) of PTX3 at 1 day was 0.845±0.045, at 
the cut-off point of 23.0 μg/L, PTX3 showed a sensitivity of 84.8%, a 
specificity of 74.1%, a negative predictive value of 85.81%, and a positive 
predictive value of 72.42%. AUC of EVLWI at 3 days was 0.838±0.048, at the 
cut-off point of 10.5 mL/kg, EVLWI showed a sensitivity of 83.9%, a specificity 
of 82.9%, a negative predictive value of 86.45%, and a positive predictive value 
of 79.79%. Their sensitivities and specificities were found to be better than 
APACHEII, SOFA score. AUC of PTX3 combined with EVLWI at 1 day was 0.886±0.038. 
On the 1st day after ICU admission, with combination of the two indicators, 
cut-off point was found to be 0.312, a sensitivity of 86.8%, a specificity of 
85.4%, a negative predictive value of 88.93%, and a positive predictive value of 
82.72%. On the 3rd day after ICU admission, AUC of PTX3 combined with EVLWI was 
0.856±0.046, and showed a cut-off of 0.471 for the prognosis of sepsis, a 
sensitivity of 85.8%, a specificity of 85.4%, a negative predictive value of 
87.97%, and a positive predictive value of 82.50%. Compared with other single 
index, a combination of above mentioned two indexes showed a better sensitivity 
and specificity.
CONCLUSIONS: PTX3 can serve as a novel prognostic indicator at early stage in 
septic patients. Combined with EVLWI, it shows important value in predicting 
prognosis of septic patients, and it also provides guidance in treatment of 
high-risk patients.