Title : Association of high SOFA score (≥10) with elevated proenkephalin levels in septic critically ill patients: A single-center cohort study from Indonesia

Abstract:

Background: Sepsis remains a major cause of morbidity and mortality in critically ill patients worldwide due to dysregulated host responses leading to multiorgan dysfunction. Early identification of patients with severe organ failure is essential to improve prognosis and optimize intensive care management. The Sequential Organ Failure Assessment (SOFA) score is widely used to assess the severity of organ dysfunction and predict outcomes in septic patients. However, additional biomarkers are still needed to complement clinical scoring systems and provide early prognostic information. Proenkephalin (PENK), a stable surrogate biomarker associated with renal dysfunction, inflammation, and systemic disease severity, has recently gained attention as a potential indicator of worsening organ failure and adverse outcomes in sepsis. Elevated PENK levels may reflect impaired kidney function and overall severity of illness, particularly in patients with high SOFA scores.

Objective: To evaluate the association between high SOFA score (≥10) and admission proenkephalin levels in septic critically ill patients.

Methods: We conducted a retrospective observational study involving adult septic patients admitted to the intensive care unit of a tertiary referral hospital in Indonesia. SOFA scores and PENK levels were recorded within the first 24 hours of ICU admission. Patients were categorized into two groups: SOFA <10 and SOFA ≥10. PENK levels were compared using the Mann–Whitney U test.

Results: A total of 98 septic critically ill patients were included in the study. Patients with SOFA score ≥10 had significantly higher admission PENK levels compared with those with SOFA score <10. Median PENK levels were 118.6 in the high SOFA group versus 76.4 in the lower SOFA group (p = 0.004). PENK in SOFA ≥10 = 118.6 vs PENK in SOFA <10 = 76.4

Biography:

Fauzio Nurul Khaira is an Internal Medicine resident from Indonesia with academic interests in critical care, infectious diseases, metabolic disorders, and systemic inflammatory conditions. His scholarly work focuses on sepsis, organ dysfunction, biomarker evaluation, and evidence-based management of critically ill patients.

His research interests include biomarker discovery, inflammatory and metabolic pathways, prognostic assessment in critical illness, and the clinical application of precision medicine in internal medicine practice. He is particularly interested in the role of novel biomarkers in predicting disease severity and outcomes in critically ill and septic patients.

Through his clinical training and academic activities, he aims to contribute to improving patient outcomes, advancing translational clinical research, and promoting data-driven approaches in internal medicine and critical care.