Early osteopontin levels predict mortality in patients with septic shock
| Autor: | Aldo Bonaventura, Jennifer Meessen, Alessandra Vecchié, Silvia Minetti, Roberto Latini, Federico Carbone, Diletta Guarducci, Francesco Bona, Marta Ferrari, Pietro Caironi, Giorgio Tulli, Edoardo Elia, N Rossi, Anna Maria Ansaldo, Daniele Ferrara, Fabrizio Montecucco |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Infection Inflammation Mortality Osteopontin Sepsis Septic shock 030204 cardiovascular system & hematology Gastroenterology 03 medical and health sciences 0302 clinical medicine stomatognathic system Internal medicine Internal Medicine Medicine Humans In patient 030212 general & internal medicine biology business.industry Septic Albumin Shock medicine.disease Prognosis Shock Septic Inflammatory biomarkers Pathophysiology Biomarkers Italy biology.protein medicine.symptom business |
| Popis: | Inflammatory biomarkers could be useful to stratify the risk of sepsis adverse outcome and potentially improving the clinical management. Here, we investigated the prognostic role of the inflammatory molecule osteopontin (OPN) in patients with severe sepsis with and without septic shock.This is a sub-analysis of 957 patients with sepsis/septic shock from the Albumin Italian Outcome Sepsis (ALBIOS) study. Alongside demographic, clinical, and laboratory data, we assessed plasmatic values of OPN at day 1, 2 and 7 after enrolment. The primary outcome was the predictive role of OPN values at day 1on death for any cause at 28 days after enrolment.Plasma OPN values at day 1 were higher in patients with septic shock and correlated with the severity of multi-organ dysfunction. Once categorized for 28-day mortality, survivors were characterized by lower OPN levels at each time point and statistically significant drop overtime (p0.001 for all). Similarly, OPN reduction during the first 7 days was associated with reduced hospitalization and mortality overtime. Multivariate logistic and Cox regression models confirmed plasma OPN at day 1 as predictor of both 28- and 90-day mortality and infection resolution as well, independently of demographic, clinical and therapeutic variables. However, this prognostic value was limited to septic shock patients.In patients with septic shock, OPN plasma levels at day 1 predict a poor clinical outcome. These results provide the rationale for future pathophysiological studies aimed at clarifying the mechanisms triggered by OPN in septic shock (ALBIOS ClinicalTrials.gov Identifier: NCT00707122). |
| Databáze: | OpenAIRE |
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