Endothelial dysfunction is an early indicator of sepsis and neutrophil degranulation of septic shock in surgical patients
| Autor: | J.M. Calvo-Vecino, Luis Mario Vaquero-Roncero, Elisa Sanchez-Barrado, Raquel Almansa, Estefanía Gómez-Pesquera, Mario Lorenzo-López, Esther Zarca, Agustin Díaz-Alvarez, Marta Aragón, Carmen González-Sánchez, Marta Martín-Fernández, José Ignacio Gómez-Herreras, Jesús Rico-Feijoo, Eduardo Tamayo, C. Abad‐Molina, Cristina Doncel, Maria Carmen Esteban-Velasco, Alberto Ríos-Llorente, Esther Gómez-Sánchez, Silvia Martín, Jesus F. Bermejo-Martin, D. Álvarez, Cesar Aldecoa, Alicia Ortega, María Heredia-Rodríguez, Dolores Calvo, José María Rodríguez López, Luis Muñoz-Bellvís, David Andaluz-Ojeda, P. Ruiz-Granado |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
Neutrophils Organ Dysfunction Scores Thrombomodulin Gastroenterology Adrenomedullin Cirugía Endothelial dysfunction Hospital Mortality Area under the curve General Medicine Middle Aged Prognosis Shock Septic Disfunción endotelial Intensive Care Units Area Under Curve Shock (circulatory) Lower GI Female Original Article SOFA score medicine.symptom Adult medicine.medical_specialty lcsh:Surgery Vascular Cell Adhesion Molecule-1 Angiopoietin-2 Sepsis Lipocalin-2 Vascular Internal medicine medicine Humans Protein Precursors General Aged Septic shock business.industry lcsh:RD1-811 Original Articles medicine.disease ROC Curve Spain Multivariate Analysis Neutrophil degranulation Surgery business Biomarkers |
| Zdroj: | BJS Open BJS Open, Vol 4, Iss 3, Pp 524-534 (2020) UVaDOC: Repositorio Documental de la Universidad de Valladolid Universidad de Valladolid UVaDOC. Repositorio Documental de la Universidad de Valladolid instname |
| ISSN: | 2474-9842 |
| Popis: | Producción Científica Background: Stratification of the severity of infection is currently based on the Sequential Organ Failure Assessment (SOFA) score, which is difficult to calculate outside the ICU. Biomarkers could help to stratify the severity of infection in surgical patients. Methods: Levels of ten biomarkers indicating endothelial dysfunction, 22 indicating emergency granulopoiesis, and six denoting neutrophil degranulation were compared in three groups of patients in the first 12 h after diagnosis at three Spanish hospitals. Results: There were 100 patients with infection, 95 with sepsis and 57 with septic shock. Seven biomarkers indicating endothelial dysfunction (mid-regional proadrenomedullin (MR-ProADM), syndecan 1, thrombomodulin, angiopoietin 2, endothelial cell-specific molecule 1, vascular cell adhesion molecule 1 and E-selectin) had stronger associations with sepsis than infection alone. MR-ProADM had the highest odds ratio (OR) in multivariable analysis (OR 11·53, 95 per cent c.i. 4·15 to 32·08; P = 0·006) and the best area under the curve (AUC) for detecting sepsis (0·86, 95 per cent c.i. 0·80 to 0·91; P < 0·001). In a comparison of sepsis with septic shock, two biomarkers of neutrophil degranulation, proteinase 3 (OR 8·09, 1·34 to 48·91; P = 0·028) and lipocalin 2 (OR 6·62, 2·47 to 17·77; P = 0·002), had the strongest association with septic shock, but lipocalin 2 exhibited the highest AUC (0·81, 0·73 to 0·90; P < 0·001). Conclusion: MR-ProADM and lipocalin 2 could be alternatives to the SOFA score in the detection of sepsis and septic shock respectively in surgical patients with infection. Instituto de Salud Carlos III (grants PI15/01959, PI15/01451 and PI16/01156) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text