INFLAMMATORY BIOMARKERS AS PREDICTORS OF MORTALITY IN SEPTIC ICU PATIENTS: UPDATED NARRATIVE REVIEW

Abstract

Introduction: Sepsis is a leading cause of mortality in intensive care units (ICUs). Early risk stratification is essential to guide management and optimize resources. Inflammatory biomarkers such as C-reactive protein (CRP), procalcitonin (PCT), interleukins (IL-6, IL-8), tumor necrosis factor alpha (TNF-α), and lactate have been studied as potential predictors of severity and mortality. Objective: To review the scientific literature on inflammatory biomarkers as predictors of mortality in septic ICU patients, analyzing their kinetics, clinical applicability, limitations, and future perspectives. Methodology: Narrative review based on articles published between 2000 and 2023 in the PubMed, Scopus, SciELO, and LILACS databases, in English, Portuguese, and Spanish. Clinical trials, observational studies, and systematic reviews of biomarkers in adult ICU patients with sepsis were included. Pediatric studies and case reports were excluded. Results: 142 articles were identified, of which 38 were included in the final analysis. PCT, IL-6, and lactate stood out as the most robust markers for predicting mortality. CRP and IL-8 showed complementary relevance, while TNF-α showed limited use due to the short detection window. Studies suggest that combining biomarkers with prognostic scores (SOFA, APACHE II) increases the accuracy of risk stratification. Conclusion: Biomarkers are useful tools in clinical practice, but they do not replace a comprehensive patient assessment. The future points to multimarker models integrated with artificial intelligence, with the potential to personalize treatment and reduce mortality.