# Clinical Value of Galectin-9, Soluble TREM-1, and Soluble CD25 Among Critically Ill Patients with Organ Failure in the Emergency Department: A Prospective Observational Study

## TL;DR

This study shows that three biomarkers can help diagnose and predict outcomes in critically ill patients with organ failure.

## Contribution

The study demonstrates the diagnostic and prognostic value of Gal-9, sTREM-1, and sCD25 in sepsis and organ failure.

## Key findings

- Gal-9, sTREM-1, and sCD25 can distinguish sepsis from non-infectious organ failure.
- Higher levels of these biomarkers correlate with increased 30-day mortality in sepsis patients.
- sCD25 is an independent risk factor for 30-day mortality in sepsis or septic shock.

## Abstract

Background/Objectives: This study investigated clinical value of galectin-9 (Gal-9), a soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), and soluble CD25 (sCD25) among critically ill patients with organ failure in the emergency department. Methods: Overall, 786 patients were enrolled and classified into non-infectious organ failure (NIOF, n = 331), sepsis (n = 266), and septic shock (n = 189). The diagnostic value of Gal-9, sTREM-1, and sCD25 were evaluated by receiver operating characteristic curve analysis. The prognostic value of the biomarkers was evaluated using Kaplan–Meier survival curve and Cox proportional hazard model analyses. Results: Gal-9, sTREM-1, and sCD25 could discriminate sepsis from NIOF (Gal-9, area under the curve [AUC], 0.599–0.678; sTREM-1, AUC, 0.616–0.695; sCD25, AUC, 0.710–0.781) and septic shock from sepsis (Gal-9, AUC, 0.562–0.667; sTREM-1, AUC, 0.572–0.676; sCD25, AUC, 0.555–0.660), respectively. Sepsis patients with higher levels of biomarkers over their cut-off value showed higher 30-day mortality compared to those with lower levels below the cut-off value (Gal-9 ≥ 14,391.80 ng/L, p < 0.001; sTREM-1 ≥ 580.62 ng/L, p < 0.001; sCD25 ≥ 1639.29 ng/L, p < 0.001; respectively) (log-rank test). sCD25 is an independent risk factor for 30-day mortality in patients with sepsis or septic shock. Conclusions: Gal-9, sTREM-1, and sCD25 showed diagnostic and prognostic value in critically ill patients with organ failure. sCD25 can predict the 30-day mortality in patients with sepsis. Gal-9, sTREM-1, and sCD25 could serve as auxiliary biomarkers to support clinicians in effective sepsis management.