Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://gr.elmerpub.com

Original Article

Volume 19, Number 2, April 2026, pages 85-99

A Novel Triple-Biomarker Score Predicts Mortality in Acute Pancreatitis

↓ Figure 1. Temporal trends of (a) VEGF, (b) von Willebrand factor, (c) endothelin, (d) E-selectin, (e) TNF-α, (f) CRP, and (g) procalcitonin across the three time points (day 1, 3, 7) stratified by survival status (survivors vs. non-survivors). VEGF: vascular endothelial growth factor; TNF-α: tumor necrosis factor-α; CRP: C-reactive protein; CI: confidence interval.

↓ Figure 2. Box plots showing the distribution of TBS values between survivors and non-survivors. vWF: von Willebrand factor; TNF-α: tumor necrosis factor-α; TBS: triple biomarker score; CRP: C-reactive protein; CI: confidence interval.

↓ Figure 3. Receiver operating characteristic (ROC) curve for the triple biomarker score (TBS) predicting in-hospital mortality. The optimal cut-off value was identified as 4952.65, using Youden’s index maximization, which yielded a sensitivity of 92.3% and a specificity of 69.0% (Youden’s index J = 0.613). vWF: von Willebrand factor; TNF-α: tumor necrosis factor-α; CRP: C-reactive protein; CI: confidence interval.

↓ Figure 4. Kaplan–Meier survival curves for patients stratified by triple biomarker score (TBS). Kaplan–Meier survival analysis demonstrated no statistically significant difference between groups (log-rank test: χ² = 2.204, P = 0.138). Although mortality was numerically lower in group 0 compared to group 1, the difference did not reach statistical significance, likely due to the limited number of events. Censored patients are indicated by tick marks. The low TBS group had significantly higher survival (98.4%) compared to the high TBS group (69.2%), with a log-rank P value < 0.001. The table below shows the number of patients at risk at each time point.

↓ **Table 1.** Specifications of Commercial Assay Kits Used for Biomarker Quantification
Biomarker	Kit name (supplier)	Catalog number	Sample type	Assay type	Detection range	Sensitivity
All samples were collected, processed, and stored according to the manufacturers’ protocols and institutional ethical guidelines. Sensitivity values are given as the minimum detectable concentration according to the respective kit insert. For CRP, results are reported in both mg/dL and mg/L; conversion factor: 1 mg/dL = 10 mg/L. Catalog numbers and kit names correspond to the commercial products used at the time of the study. VEGF: vascular endothelial growth factor; vWF: von Willebrand factor; TNF-α: tumor necrosis factor-α; CRP: C-reactive protein; ELISA: enzyme-linked immunosorbent assay.
VEGF	Human VEGF165 ELISA Kit (Cloud-Clone Corp.)	SEB696Hu	Plasma	Sandwich ELISA	15.6–1,000 pg/mL	< 5.8 pg/mL
Endothelin-1	Human Endothelin 1 ELISA Kit (Cloud-Clone Corp.)	CEA482Hu	Plasma	Sandwich ELISA	6.17–500 pg/mL	< 2.71 pg/mL
vWF	Human vWF ELISA Kit (Cloud-Clone Corp.)	SEB696Hu	Plasma	Sandwich ELISA	15.6–1,000 pg/mL	< 5.8 pg/mL
E-selectin	Human SELE ELISA Kit (Cloud-Clone Corp.)	SEA029Hu	Plasma	Sandwich ELISA	39–2,500 pg/mL	< 17 pg/mL
Procalcitonin	Human PCT ELISA Kit (Cloud-Clone Corp.)	SEA689Hu	Plasma	Sandwich ELISA	31.2–2,000 pg/mL	< 12.4 pg/mL
TNF-α	Human TNF-α ELISA Kit (Vector-Best)	VE-ELH-TNFa	Serum	Sandwich ELISA	15.6–1,000 pg/mL	< 5.0 pg/mL
CRP	CRP LATEX Kit (Monlab Reagents)	3100	Serum	Latex turbidimetric immunoassay	0.2–20 mg/dL (2–200 mg/L)	< 0.2 mg/dL (2 mg/L)

↓ Table 1. Specifications of Commercial Assay Kits Used for Biomarker Quantification

Biomarker

Kit name (supplier)

Catalog number

Sample type

Assay type

Detection range

Sensitivity

All samples were collected, processed, and stored according to the manufacturers’ protocols and institutional ethical guidelines. Sensitivity values are given as the minimum detectable concentration according to the respective kit insert. For CRP, results are reported in both mg/dL and mg/L; conversion factor: 1 mg/dL = 10 mg/L. Catalog numbers and kit names correspond to the commercial products used at the time of the study. VEGF: vascular endothelial growth factor; vWF: von Willebrand factor; TNF-α: tumor necrosis factor-α; CRP: C-reactive protein; ELISA: enzyme-linked immunosorbent assay.

VEGF

Human VEGF165 ELISA Kit (Cloud-Clone Corp.)

SEB696Hu

Plasma

Sandwich ELISA

15.6–1,000 pg/mL

< 5.8 pg/mL

Endothelin-1

Human Endothelin 1 ELISA Kit (Cloud-Clone Corp.)

CEA482Hu

Plasma

Sandwich ELISA

6.17–500 pg/mL

< 2.71 pg/mL

vWF

Human vWF ELISA Kit (Cloud-Clone Corp.)

SEB696Hu

Plasma

Sandwich ELISA

15.6–1,000 pg/mL

< 5.8 pg/mL

E-selectin

Human SELE ELISA Kit (Cloud-Clone Corp.)

SEA029Hu

Plasma

Sandwich ELISA

39–2,500 pg/mL

< 17 pg/mL

Procalcitonin

Human PCT ELISA Kit (Cloud-Clone Corp.)

SEA689Hu

Plasma

Sandwich ELISA

31.2–2,000 pg/mL

< 12.4 pg/mL

TNF-α

Human TNF-α ELISA Kit (Vector-Best)

VE-ELH-TNFa

Serum

Sandwich ELISA

15.6–1,000 pg/mL

< 5.0 pg/mL

CRP

CRP LATEX Kit (Monlab Reagents)

3100

Serum

Latex turbidimetric immunoassay

0.2–20 mg/dL (2–200 mg/L)

< 0.2 mg/dL (2 mg/L)

↓ **Table 2.** Patient Characteristics and Clinical Outcomes Stratified by Disease Severity
Characteristic	Mild course group (n = 68)	Severe course group (n = 32)	Subgroup A: worsened (n = 17)	Subgroup B: improved (n = 15)
SD: standard deviation; IQR: interquartile range; BMI: body mass index; ICU: intensive care unit.
Age, years, mean ± SD (range)	48.0 ± 12.5 (19–82)	49.5 ± 11.8 (16–79)	50.0 ± 10.1 (26–79)	49.0 ± 13.8 (16–75)
Male sex, n (%)	30 (44.1)	16 (50.0)	8 (47.1)	8 (53.3)
Weight, kg, mean ± SD (range)	77.0 ± 15.0 (37–111)	79.0 ± 12.5 (53–106)	80.0 ± 10.5 (55–95)	78.0 ± 14.5 (53–106)
Height, cm, mean ± SD (range)	166.0 ± 8.5 (144–189)	163.5 ± 7.5 (147–178)	163.0 ± 8.0 (147–175)	164.0 ± 7.0 (156–178)
BMI, kg/m², mean ± SD (range)	27.0 ± 4.5 (22–37)	29.5 ± 5.5 (22–44)	30.0 ± 5.0 (24–41)	29.0 ± 6.0 (22–44)
Hospital stay, days, mean ± SD (range)	8.56 ± 5.37 (1–31)	14 ± 7.83 (3–42)	18.53 ± 8.16 (7–42)	8.87 ± 2.56 (3–13)
ICU stay, days, mean ± SD (range)	1.62 ± 1.42 (1–6)	7.30 ± 8.60 (1–42)	9.81 ± 10.33 (1–42)	3.64 ± 2.73 (1–9)
Time from onset of symptoms to admission, days
Mean ± SD	136.35 ± 19.68	55.69 ± 19.05	61.59 ± 29.51	49 ± 24.08
Median	30	9	7	14
IQR	358	25	25	67
Complications, n (%)
Pancreatic necrosis	3 (4.41%)	9 (28.12%)	6 (35.29%)	3 (20%)
Pseudocyst	3 (4.41%)	3 (9.37%)	1 (5.88%)	2 (13.3%
Infected necrosis	10 (14.7%)	13 (40.62%)	8 (47.05%)	5 (53.3%)
Organ failure	8 (11.76%)	3 (9.37%)	1 (5.88%)	2 (13.3%)
Mortality, n (%)	3 (4.4%)	10 (31.3%)	10 (58.8%)	0 (0)

↓ Table 2. Patient Characteristics and Clinical Outcomes Stratified by Disease Severity

Characteristic

Mild course group (n = 68)

Severe course group (n = 32)

Subgroup A: worsened (n = 17)

Subgroup B: improved (n = 15)

SD: standard deviation; IQR: interquartile range; BMI: body mass index; ICU: intensive care unit.

Age, years, mean ± SD (range)

48.0 ± 12.5 (19–82)

49.5 ± 11.8 (16–79)

50.0 ± 10.1 (26–79)

49.0 ± 13.8 (16–75)

Male sex, n (%)

30 (44.1)

16 (50.0)

8 (47.1)

8 (53.3)

Weight, kg, mean ± SD (range)

77.0 ± 15.0 (37–111)

79.0 ± 12.5 (53–106)

80.0 ± 10.5 (55–95)

78.0 ± 14.5 (53–106)

Height, cm, mean ± SD (range)

166.0 ± 8.5 (144–189)

163.5 ± 7.5 (147–178)

163.0 ± 8.0 (147–175)

164.0 ± 7.0 (156–178)

BMI, kg/m², mean ± SD (range)

27.0 ± 4.5 (22–37)

29.5 ± 5.5 (22–44)

30.0 ± 5.0 (24–41)

29.0 ± 6.0 (22–44)

Hospital stay, days, mean ± SD (range)

8.56 ± 5.37 (1–31)

14 ± 7.83 (3–42)

18.53 ± 8.16 (7–42)

8.87 ± 2.56 (3–13)

ICU stay, days, mean ± SD (range)

1.62 ± 1.42 (1–6)

7.30 ± 8.60 (1–42)

9.81 ± 10.33 (1–42)

3.64 ± 2.73 (1–9)

Time from onset of symptoms to admission, days

Mean ± SD

136.35 ± 19.68

55.69 ± 19.05

61.59 ± 29.51

49 ± 24.08

Median

IQR

358

Complications, n (%)

Pancreatic necrosis

3 (4.41%)

9 (28.12%)

6 (35.29%)

3 (20%)

Pseudocyst

3 (4.41%)

3 (9.37%)

1 (5.88%)

2 (13.3%

Infected necrosis

10 (14.7%)

13 (40.62%)

8 (47.05%)

5 (53.3%)

Organ failure

8 (11.76%)

3 (9.37%)

1 (5.88%)

2 (13.3%)

Mortality, n (%)

3 (4.4%)

10 (31.3%)

10 (58.8%)

0 (0)

↓ **Table 3.** Correlation Matrix of Biomarkers on Admission (Adm) Day
Correlations
Data are presented as Spearman correlation coefficient (r). The diagonal of 1.0 represents the correlation of each variable with itself. *Correlation is significant at the 0.01 level (two-tailed). Correlation is significant at the 0.05 level (two-tailed). VEGF: vascular endothelial growth factor; vWF: von Willebrand factor; TNF: tumor necrosis factor; CRP: C-reactive protein; End: endothelin-1; E-Sel: E-selectin; Proc: procalcitonin; Sig.: significance.
Spearman’s rho	VEGF_Adm	Correlation coefficient	1.000	0.042	0.455**	0.205*	0.364**	0.236*	0.377**
		Sig. (two-tailed)		0.681	0.000	0.041	0.000	0.018	0.000
		N	100	100	100	100	100	100	100
	vWF_Adm	Correlation coefficient	0.042	1,000	0.039	0.177	–0.038	0.094	0.192
		Sig. (two-tailed)	0.681		0.703	0.078	0.709	0.354	0.056
		N	100	100	100	100	100	100	100
	End_Adm	Correlation coefficient	0.455**	0.039	1.000	0.169	0.684**	0.429**	0.598**
		Sig. (two-tailed)	0.000	0.703		0.093	0.000	0.000	0.000
		N	100	100	100	100	100	100	100
	E-Sel_Adm	Correlation coefficient	0.205*	0.177	0.169	1.000	0.211*	0.064	0.299**
		Sig. (two-tailed)	0.041	0.078	0.093		0.035	0.526	0.002
		N	100	100	100	100	100	100	100
	TNF_Adm	Correlation coefficient	0.364**	–0.038	0.684**	0.211*	1.000	0.276**	0.596**
		Sig. (two-tailed)	0.000	0.709	0.000	0.035		0.005	0.000
		N	100	100	100	100	100	100	100
	CRP_Adm	Correlation coefficient	0.236*	0.094	0.429**	0.064	0.276**	1.000	0.433**
		Sig. (two-tailed)	0.018	0.354	0.000	0.526	0.005		0.000
		N	100	100	100	100	100	100	100
	Proc_Adm	Correlation coefficient	0.377**	0.192	0.598**	0.299**	0.596**	0.433**	1.000
		Sig. (two-tailed)	0.000	0.056	0.000	0.002	0.000	0.000
		N	100	100	100	100	100	100	100

↓ Table 3. Correlation Matrix of Biomarkers on Admission (Adm) Day

Correlations

VEGF_Adm

vWF_Adm

End_Adm

E-Sel_Adm

TNF_Adm

CRP_Adm

Proc_Adm

Data are presented as Spearman correlation coefficient (r). The diagonal of 1.0 represents the correlation of each variable with itself. **Correlation is significant at the 0.01 level (two-tailed). *Correlation is significant at the 0.05 level (two-tailed). VEGF: vascular endothelial growth factor; vWF: von Willebrand factor; TNF: tumor necrosis factor; CRP: C-reactive protein; End: endothelin-1; E-Sel: E-selectin; Proc: procalcitonin; Sig.: significance.

Spearman’s rho

VEGF_Adm

Correlation coefficient

1.000

0.042

0.455**

0.205*

0.364**

0.236*

0.377**

Sig. (two-tailed)

0.681

0.000

0.041

0.000

0.018

0.000

100

vWF_Adm

Correlation coefficient

0.042

1,000

0.039

0.177

–0.038

0.094

0.192

Sig. (two-tailed)

0.681

0.703

0.078

0.709

0.354

0.056

100

End_Adm

Correlation coefficient

0.455**

0.039

1.000

0.169

0.684**

0.429**

0.598**

Sig. (two-tailed)

0.000

0.703

0.093

0.000

100

E-Sel_Adm

Correlation coefficient

0.205*

0.177

0.169

1.000

0.211*

0.064

0.299**

Sig. (two-tailed)

0.041

0.078

0.093

0.035

0.526

0.002

100

TNF_Adm

Correlation coefficient

0.364**

–0.038

0.684**

0.211*

1.000

0.276**

0.596**

Sig. (two-tailed)

0.000

0.709

0.000

0.035

0.005

0.000

100

CRP_Adm

Correlation coefficient

0.236*

0.094

0.429**

0.064

0.276**

1.000

0.433**

Sig. (two-tailed)

0.018

0.354

0.000

0.526

0.005

0.000

100

Proc_Adm

Correlation coefficient

0.377**

0.192

0.598**

0.299**

0.596**

0.433**

1.000

Sig. (two-tailed)

0.000

0.056

0.000

0.002

0.000

100

↓ **Table 4.** Correlation Matrix of Biomarkers on Day 3 of Hospitalization
Correlations
Data are presented as Spearman correlation coefficient (r). The diagonal of 1.0 represents the correlation of each variable with itself. *Correlation is significant at the 0.01 level (two-tailed). Correlation is significant at the 0.05 level (two-tailed). 3d: day 3; VEGF: vascular endothelial growth factor; vWF: von Willebrand factor; TNF: tumor necrosis factor; CRP: C-reactive protein; End: endothelin-1; E-Sel: E-selectin; Proc: procalcitonin; Sig.: significance.
Spearman’s rho	VEGF_3d	Correlation coefficient	1.000	0.181	0.328**	0.426**	0.277**	0.333**	0.238*
		Sig. (two-tailed)		0.072	0.001	0.000	0.005	0.001	0.017
		N	100	100	100	100	100	100	100
	vWF_3d	Correlation coefficient	0.181	1.000	0.207*	0.137	0.255*	0.262**	0.209*
		Sig. (two-tailed)	0.072		0.038	0.174	0.011	0.009	0.037
		N	100	100	100	100	100	100	100
	End_3d	Correlation coefficient	0.328**	0.207*	1.000	0.402**	0.696**	0.562**	0.722**
		Sig. (two-tailed)	0.001	0.038		0.000	0.000	0.000	0.000
		N	100	100	100	100	100	100	100
	E-Sel_3d	Correlation coefficient	0.426**	0.137	0.402**	1.000	0.485**	0.543**	0.430**
		Sig. (two-tailed)	0.000	0.174	0.000		0.000	0.000	0.000
		N	100	100	100	100	100	100	100
	TNF_3d	Correlation coefficient	0.277**	0.255*	0.696**	0.485**	1.000	0.517**	0.642**
		Sig. (two-tailed)	0.005	0.011	0.000	0.000		0.000	0.000
		N	100	100	100	100	100	100	100
	CRP_3d	Correlation coefficient	0.333**	0.262**	0.562**	0.543**	0.517**	1.000	0.555**
		Sig. (two-tailed)	0.001	0.009	0.000	0.000	0.000	.	0.000
		N	100	100	100	100	100	100	100
	Proc_3d	Correlation coefficient	0.238*	0.209*	0.722**	0.430**	0.642**	0.555**	1.000
		Sig. (two-tailed)	0.017	0.037	0.000	0.000	0.000	0.000
		N	100	100	100	100	100	100	100

↓ Table 4. Correlation Matrix of Biomarkers on Day 3 of Hospitalization

Correlations

VEGF_3d

vWF_3d

End_3d

E-Sel_3d

TNF_3d

CRP_3d

Proc_3d

Data are presented as Spearman correlation coefficient (r). The diagonal of 1.0 represents the correlation of each variable with itself. **Correlation is significant at the 0.01 level (two-tailed). *Correlation is significant at the 0.05 level (two-tailed). 3d: day 3; VEGF: vascular endothelial growth factor; vWF: von Willebrand factor; TNF: tumor necrosis factor; CRP: C-reactive protein; End: endothelin-1; E-Sel: E-selectin; Proc: procalcitonin; Sig.: significance.

Spearman’s rho

VEGF_3d

Correlation coefficient

1.000

0.181

0.328**

0.426**

0.277**

0.333**

0.238*

Sig. (two-tailed)

0.072

0.001

0.000

0.005

0.001

0.017

100

vWF_3d

Correlation coefficient

0.181

1.000

0.207*

0.137

0.255*

0.262**

0.209*

Sig. (two-tailed)

0.072

0.038

0.174

0.011

0.009

0.037

100

End_3d

Correlation coefficient

0.328**

0.207*

1.000

0.402**

0.696**

0.562**

0.722**

Sig. (two-tailed)

0.001

0.038

0.000

100

E-Sel_3d

Correlation coefficient

0.426**

0.137

0.402**

1.000

0.485**

0.543**

0.430**

Sig. (two-tailed)

0.000

0.174

0.000

100

TNF_3d

Correlation coefficient

0.277**

0.255*

0.696**

0.485**

1.000

0.517**

0.642**

Sig. (two-tailed)

0.005

0.011

0.000

100

CRP_3d

Correlation coefficient

0.333**

0.262**

0.562**

0.543**

0.517**

1.000

0.555**

Sig. (two-tailed)

0.001

0.009

0.000

100

Proc_3d

Correlation coefficient

0.238*

0.209*

0.722**

0.430**

0.642**

0.555**

1.000

Sig. (two-tailed)

0.017

0.037

0.000

100

↓ **Table 5.** Data for All Seven Biomarkers at Admission, Day 3, and Day 7, Stratified by the Three Clinically Relevant Subgroups (Mild Course, Worsened Subgroup A, Improved Subgroup B).
Subgroups	Admission	Day 3	Day 7
SD: standard deviation; Min: minimum; Max: maximum; VEGF: vascular endothelial growth factor; vWF: von Willebrand factor; TNF: tumor necrosis factor; CRP: C-reactive protein; End: endothelin-1; E-Sel: E-selectin; Proc: procalcitonin.
Mild course (n = 68)	Mean	120.1985	116.0103	6.7050	67.2397	6.1394	10.8115	0.4509	136.7809	93.9397	6.3775	56.4074	4.0731	9.6190	0.2140	130.3191	86.0426	5.1137	47.9147	3.2999	8.6996	0.0896
	N	68	68	68	68	68	68	68	68	68	68	68	68	68	68	68	68	68	68	68	68	68
	SD	37.27671	22.64100	0.62950	8.72104	1.29862	2.67186	0.16683	37.85918	20.75935	0.46722	7.79302	0.83722	1.60439	0.09359	41.18839	17.14541	0.44807	6.57815	0.69896	1.28015	0.01165
	Min	35.00	61.00	4.80	35.30	4.12	6.98	0.12	40.00	59.00	4.02	30.20	3.04	6.03	0.06	50.40	56.00	3.93	25.40	2.51	5.98	0.05
	Max	260.00	173.00	7.82	79.20	11.96	15.20	0.91	270.00	165.80	7.23	68.20	9.97	13.96	0.42	288.70	154.00	6.18	59.80	7.40	12.03	0.11
Worsened (subgroup A, n = 17)	Mean	194.7706	122.0118	8.9129	72.7941	17.5571	20.5294	1.3029	209.7647	136.0706	9.4947	87.3529	28.4971	34.9235	2.6853	230.1529	141.0118	9.9376	99.3118	37.5529	51.6706	8.3018
	N	17	17	17	17	17	17	17	17	17	17	17	17	17	17	17	17	17	17	17	17	17
	SD	93.57457	35.95207	0.29995	8.68083	5.15605	4.86181	0.36467	96.28630	45.88323	0.52547	8.13297	9.87700	6.66638	0.67861	94.56945	45.16745	0.93069	8.18305	15.77910	12.82803	1.91778
	Min	50.00	66.30	8.30	50.30	6.20	10.00	0.52	53.20	59.00	8.70	70.00	8.20	20.20	0.65	55.30	77.00	8.60	85.00	15.00	25.00	1.40
	Max	470.00	176.00	9.28	85.00	28.00	29.80	1.96	508.00	192.00	10.60	100.00	40.00	48.00	3.90	520.00	224.00	11.50	109.70	62.00	67.00	9.98
Improved (subgroup B, n = 15)	Mean	174.2200	126.1067	8.5033	69.3600	15.9127	12.4467	1.0227	161.9333	104.0000	9.0807	58.3467	12.1313	11.7260	0.8533	155.9600	90.8467	7.8953	45.3267	8.0407	10.2000	0.7820
	N	15	15	15	15	15	15	15	15	15	15	15	15	15	15	15	15	15	15	15	15	15
	SD	88.63886	36.38336	0.36233	8.32104	5.58683	2.72341	0.28702	96.54062	33.35583	0.55595	9.65970	3.64873	2.96259	0.15003	85.00817	22.18065	0.55575	5.88818	2.49135	2.58706	0.12712
	Min	46.00	61.00	8.00	46.00	6.10	8.00	0.52	39.00	59.00	8.20	39.00	5.20	8.00	0.40	38.00	56.00	6.80	35.00	4.00	7.80	0.40
	Max	460.00	173.00	9.20	78.00	24.90	20.00	1.60	430.00	166.00	9.90	68.00	19.00	19.00	1.10	415.00	154.00	8.62	61.00	12.90	18.00	0.98
Total	Mean	140.9790	118.5450	7.3501	68.5020	9.5464	12.7088	0.6815	152.9610	102.6110	7.3129	61.9590	9.4339	14.2368	0.7300	151.1370	96.1080	6.3510	56.2640	9.8340	16.2297	1.5895
	N	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100
	SD	66.53957	27.53462	1.09912	8.82113	5.91478	4.76298	0.41528	67.32353	32.14688	1.45875	14.10197	10.06817	9.96256	0.96190	70.63113	31.91012	1.98531	20.71782	14.25475	16.99393	3.15873
	Min	35.00	61.00	4.80	35.30	4.12	6.98	0.12	39.00	59.00	4.02	30.20	3.04	6.03	0.06	38.00	56.00	3.93	25.40	2.51	5.98	0.05
	Max	470.00	176.00	9.28	85.00	28.00	29.80	1.96	508.00	192.00	10.60	100.00	40.00	48.00	3.90	520.00	224.00	11.50	109.70	62.00	67.00	9.98

↓ Table 5. Data for All Seven Biomarkers at Admission, Day 3, and Day 7, Stratified by the Three Clinically Relevant Subgroups (Mild Course, Worsened Subgroup A, Improved Subgroup B).

Subgroups

Admission

Day 3

Day 7

VEGF

vWF

End

E-Sel

TNF

CRP

Proc

VEGF

vWF

Endo

E-Sel

TNF

CRP

Proc

VEGF

vWF

Endo

E-Sel

TNF

CRP

Proc

SD: standard deviation; Min: minimum; Max: maximum; VEGF: vascular endothelial growth factor; vWF: von Willebrand factor; TNF: tumor necrosis factor; CRP: C-reactive protein; End: endothelin-1; E-Sel: E-selectin; Proc: procalcitonin.

Mild course (n = 68)

Mean

120.1985

116.0103

6.7050

67.2397

6.1394

10.8115

0.4509

136.7809

93.9397

6.3775

56.4074

4.0731

9.6190

0.2140

130.3191

86.0426

5.1137

47.9147

3.2999

8.6996

0.0896

37.27671

22.64100

0.62950

8.72104

1.29862

2.67186

0.16683

37.85918

20.75935

0.46722

7.79302

0.83722

1.60439

0.09359

41.18839

17.14541

0.44807

6.57815

0.69896

1.28015

0.01165

Min

35.00

61.00

4.80

35.30

4.12

6.98

0.12

40.00

59.00

4.02

30.20

3.04

6.03

0.06

50.40

56.00

3.93

25.40

2.51

5.98

0.05

Max

260.00

173.00

7.82

79.20

11.96

15.20

0.91

270.00

165.80

7.23

68.20

9.97

13.96

0.42

288.70

154.00

6.18

59.80

7.40

12.03

0.11

Worsened (subgroup A, n = 17)

Mean

194.7706

122.0118

8.9129

72.7941

17.5571

20.5294

1.3029

209.7647

136.0706

9.4947

87.3529

28.4971

34.9235

2.6853

230.1529

141.0118

9.9376

99.3118

37.5529

51.6706

8.3018

93.57457

35.95207

0.29995

8.68083

5.15605

4.86181

0.36467

96.28630

45.88323

0.52547

8.13297

9.87700

6.66638

0.67861

94.56945

45.16745

0.93069

8.18305

15.77910

12.82803

1.91778

Min

50.00

66.30

8.30

50.30

6.20

10.00

0.52

53.20

59.00

8.70

70.00

8.20

20.20

0.65

55.30

77.00

8.60

85.00

15.00

25.00

1.40

Max

470.00

176.00

9.28

85.00

28.00

29.80

1.96

508.00

192.00

10.60

100.00

40.00

48.00

3.90

520.00

224.00

11.50

109.70

62.00

67.00

9.98

Improved (subgroup B, n = 15)

Mean

174.2200

126.1067

8.5033

69.3600

15.9127

12.4467

1.0227

161.9333

104.0000

9.0807

58.3467

12.1313

11.7260

0.8533

155.9600

90.8467

7.8953

45.3267

8.0407

10.2000

0.7820

88.63886

36.38336

0.36233

8.32104

5.58683

2.72341

0.28702

96.54062

33.35583

0.55595

9.65970

3.64873

2.96259

0.15003

85.00817

22.18065

0.55575

5.88818

2.49135

2.58706

0.12712

Min

46.00

61.00

8.00

46.00

6.10

8.00

0.52

39.00

59.00

8.20

39.00

5.20

8.00

0.40

38.00

56.00

6.80

35.00

4.00

7.80

0.40

Max

460.00

173.00

9.20

78.00

24.90

20.00

1.60

430.00

166.00

9.90

68.00

19.00

1.10

415.00

154.00

8.62

61.00

12.90

18.00

0.98

Total

Mean

140.9790

118.5450

7.3501

68.5020

9.5464

12.7088

0.6815

152.9610

102.6110

7.3129

61.9590

9.4339

14.2368

0.7300

151.1370

96.1080

6.3510

56.2640

9.8340

16.2297

1.5895

100

66.53957

27.53462

1.09912

8.82113

5.91478

4.76298

0.41528

67.32353

32.14688

1.45875

14.10197

10.06817

9.96256

0.96190

70.63113

31.91012

1.98531

20.71782

14.25475

16.99393

3.15873

Min

35.00

61.00

4.80

35.30

4.12

6.98

0.12

39.00

59.00

4.02

30.20

3.04

6.03

0.06

38.00

56.00

3.93

25.40

2.51

5.98

0.05

Max

470.00

176.00

9.28

85.00

28.00

29.80

1.96

508.00

192.00

10.60

100.00

40.00

48.00

3.90

520.00

224.00

11.50

109.70

62.00

67.00

9.98

↓ **Table 6.** Logistic Regression Analysis for Mortality Prediction
Variables in the equation
^aVariable(s) entered on step 1: TBS. Dependent variable: mortality (1 = died, 0 = survived). Model fit: Hosmer-Lemeshow χ² = 6.21, df = 8, P = 0.62; Nagelkerke R² = 0.51. TBS: triple biomarker score; SE: standard error; Sig.: significance; CI: confidence interval.
Step 1^a	TBS	3.283	1.066	9.481	1	0.002	26.667	3.298–215.586
	Constant	–4.094	1.008	16.489	1	0.000	0.017

↓ Table 6. Logistic Regression Analysis for Mortality Prediction

Variables in the equation

Wald

Sig.

Exp(B)

95% CI for EXP(B) (lower–upper)

^aVariable(s) entered on step 1: TBS. Dependent variable: mortality (1 = died, 0 = survived). Model fit: Hosmer-Lemeshow χ² = 6.21, df = 8, P = 0.62; Nagelkerke R² = 0.51. TBS: triple biomarker score; SE: standard error; Sig.: significance; CI: confidence interval.

Step 1^a

TBS

3.283

1.066

9.481

0.002

26.667

3.298–215.586

Constant

–4.094

1.008

16.489

0.000

0.017