This study’s objective was to evaluate the endothelial biomarkers’ ability to predict clinical deterioration of patients (specifically with suspected sepsis) admitted to the emergency department. The sVEGFR2 and suPAR biomarkers’ abilities were studied and compared to the conventional clinical and biological parameters. The biomarkers’ performance was also assessed based on the presence of sepsis (as per the updated definitions of Sepsis-3).

Adult patients suspected of acute bacterial infection and sepsis were enrolled for this study, but only those with confirmed infection were analyzed. Kinetics of biomarkers and organ dysfunction were collected at T0, T6, and T24 hours after their admission to assess the performances of suPAR, sVEGFR2, and procalcitonin. The primary outcome was the observed deterioration within 72 hours and was defined as a result of relevant outcomes such as death, intensive care unit admission, and SOFA score increase validated by an independent adjudication committee.

The current findings highlight the potential interest of the sVEGFR2 protein, alone or in combination with suPAR, to diagnose initial endothelium stress and predict/anticipate subsequent organ dysfunction. This suitable tool for routine test measurement, with time to results within an hour (one-time measurement required), could be used together with other laboratory findings and clinical assessments, to assist in prediction of the risk of deterioration and safely ruling out infected patients after emergency department admission.