Endothelial dysfunction is an early indicator of sepsis and neutrophil degranulation of septic shock in surgical patients

Autor: M. Martin‐Fernandez, L. M. Vaquero‐Roncero, R. Almansa, E. Gómez‐Sánchez, S. Martín, E. Tamayo, M. C. Esteban‐Velasco, P. Ruiz‐Granado, M. Aragón, D. Calvo, J. Rico‐Feijoo, A. Ortega, E. Gómez‐Pesquera, M. Lorenzo‐López, J. López, C. Doncel, C. González‐Sanchez, D. Álvarez, E. Zarca, A. Ríos‐Llorente, A. Diaz‐Alvarez, E. Sanchez‐Barrado, D. Andaluz‐Ojeda, J. M. Calvo‐Vecino, L. Muñoz‐Bellvís, J. I. Gomez‐Herreras, C. Abad‐Molina, J. F. Bermejo‐Martin, C. Aldecoa, M. Heredia‐Rodríguez
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: BJS Open, Vol 4, Iss 3, Pp 524-534 (2020)
Druh dokumentu: article
ISSN: 2474-9842
DOI: 10.1002/bjs5.50265
Popis: 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
Databáze: Directory of Open Access Journals