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Research Snapshot Theater: Shock, Adult II

Prognostic Value of Blood Biomarkers in Shock of Unspecified Origin

Sunday, March 22, 2026
11:00 AM - 12:00 PM Central Time
Location: Connections Central - RST 16
  • NM

    Noam Makmal, MD MPH

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • AN

    Atif Nasim, MD

    Postdoctoral research fellow
    Beth Israel Deaconess Medical Center BIDMC

    Disclosure information not submitted.

  • JD

    Jonathan Dreyfuss, PhD

    Director
    Bioinformatics and Biostatistics Core, Joslin Diabetes Center

    Disclosure information not submitted.

  • RS

    Riya Sharma, MPH

    Clinical research coordinator
    Beth Israel Deaconess Medical Center BIDMC

    Disclosure information not submitted.

  • MA

    Mansi Arora, MD

    Clinical research coordinator
    Beth Israel Deaconess Medical Center BIDMC

    Disclosure information not submitted.

  • SS

    Shahzad Shaefi, MD MPH

    Principal investigator
    Beth Israel Deaconess Medical Center BIDMC

    Disclosure information not submitted.

Introduction: Critical illness comprises complex and heterogenous disease states, yet deep understanding of the disease process in the individual is lacking. Biomarkers may provide valuable insight into the mechanisms of organ dysfunction in the ICU, offering important diagnostic and prognostic information to guide the care of critically ill patients.


Methods: In this single-center prospective study, we enrolled ICU patients aged ≥18 years with shock of unspecified origin, defined by lactate >2 mmol/L and vasopressor requirement. Blood samples were collected every other day during ICU stay and later batch-analyzed using a 29-plex biomarker panel (Eve Technologies, Canada).


Results: A total of 43 patients were included (median age: 66.9 years [IQR (interquartile range): 55.4–74]; 53.5% males). Septic shock was most common (41.9%), followed by mixed shock (32.6%). Median SOFA score at admission was 9 (IQR: 7–12), with in-hospital mortality of 37.2%. Survivors had lower SOFA scores than non-survivors (8 [IQR: 6–11] vs 11.5 [IQR: 9.5–13.3]; p=0.017). Baseline biomarkers reflecting apoptosis (sFAS [ρ=0.46]), endothelial activation (sICAM-1 [ρ=0.34], sVCAM-1 [ρ=0.46]), neutrophil-activation (Lipocalin-2 [ρ=0.38], MMP-8 [ρ=0.32]), and pro-inflammatory chemokines (CXCL6 [ρ=0.41], IL-1α [ρ=0.42], IL-8 [ρ=0.38], FABP-4 [ρ=0.45]) significantly (p < 0.05) correlated with SOFA. Notably, non-survivors had higher levels of pro-inflammatory mediators CXCL16, CXCL6, and IL-8 (all p< 0.05). While individual biomarkers had lower area under the curve (AUC) than SOFA (0.719 [95% CI: 0.57-0.87]), combining SOFA with CXCL6, CXCL16, or IL-8 improved discrimination (AUCs: 0.748 [95% CI: 0.6-0.89]; 0.745 [95% CI: 0.59-0.9]; 0.734 [95% CI: 0.58-0.89] respectively).


Conclusions: The association of CXCL6, CXCL16, and IL-8 with poor prognosis underscores the role of excessive inflammation in driving organ dysfunction and adverse outcomes in critical illness. The observed improvement in SOFA score’s predictive performance when combined with the three biomarkers suggests that immune profiling could be utilized as an adjuvant tool to clinical assessment for early risk stratification.