RT info:eu-repo/semantics/article
T1 Endothelial dysfunction is an early indicator of sepsis and neutrophil degranulation of septic shock in surgical patients
A1 Martín Fernández, Marta
A1 Vaquero Roncero, Luis Mario
A1 Almansa Mora, Raquel
A1 Gómez Sánchez, Esther
A1 Martín, Silvia
A1 Tamayo Gómez, Eduardo
A1 Esteban Velasco, María Carmen
A1 Ruiz Granado, Patricia
A1 Aragón, Marta
A1 Calvo, Dolores
A1 Rico Feijoo, Jesús
A1 Ortega, A.
A1 Gómez Pesquera, Estefanía
A1 Lorenzo López, Mario
A1 López Sánchez, Jaime
A1 Doncel, Cristina
A1 González Sánchez, Carmen
A1 Álvarez, D.
A1 Zarca, E.
A1 Ríos Llorente, Alberto
A1 Díaz Álvarez, A.
A1 Sánchez Barrado, Elisa
A1 Andaluz Ojeda, David
A1 Calvo Vecino, José María
A1 Muñoz Bellvís, Luis
A1 Gómez Herreras, José Ignacio
A1 Abad Molina, Cristina
A1 Bermejo Martín, Jesús Francisco
A1 Aldecoa Álvarez Santullano, César Enrique
A1 Heredia Rodríguez, María
K1 Endothelial dysfunction
K1 Disfunción endotelial
K1 Sepsis
K1 Surgery
K1 Cirugía
AB 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.
PB Oxford University Press
SN 2474-9842
YR 2020
FD 2020
LK http://uvadoc.uva.es/handle/10324/45461
UL http://uvadoc.uva.es/handle/10324/45461
LA eng
NO BJS Open, 2020, vol. 4, n. 3. p. 524-534
NO Producción Científica
DS UVaDOC
RD 23-nov-2024