N-myc and STAT interactor is a novel biomarker for predicting the severity and clinical outcome of sepsis: a prospective research

Background Sepsis is prevalent and life-threatening condition that is often associated with high mortality rates. Early stratification is significantly associated with prognosis. Traditional biomarkers show low specificity, while scoring systems are time-consuming. This study aimed to evaluate the predictive value of a novel biomarker (N-myc and STAT interactor (NMI)) in assessing disease severity and clinical outcome in sepsis. Methods A total of 399 adult patients diagnosed with sepsis were recruited. The least absolute shrinkage and selection operator (LASSO), logistic regression analysis, and receiver operating characteristic curve (ROC) were used to prove the predictive value of NMI in serum for disease severity (septic shock) and clinical outcome (30-day mortality) in the training set (n = 302). Internal validation (n = 97) was utilized to guarantee the stability of the findings. Results The study revealed that NMI was independently associated with 30-day mortality and the occurrence of septic shock through LASSO and logistic analysis. The NMI concentrations of patients with septic shock (166.1 [98.8, 437.5]) and non-survivors (208.7 [113.5, 809.6]) were higher than those of sepsis patients (54.2 [45.4, 64.8]) and survivors (59.3 [48.0, 90.2]), respectively. The area under the curve (AUC) of NMI for predicting mortality and septic shock was 0.86 and 0.92, respectively, which significantly outperformed other biomarkers and scoring systems. The AUCs of new scoring systems containing NMI were all remarkably higher than the original scoring systems (APACHE II, SOFA, qSOFA) for the prediction of clinical outcome and disease severity. Stratification of NMI concentrations in Kaplan-Meier survival curves proved the 30-day survival rate decreased with the increasing level of NMI ( P < 0.001). Conclusions Serum NMI can serve as a novel parameter to predict the severity and clinical outcome of sepsis, potentially facilitating timely disease stratification and providing certain guidance for clinical decision-making.