Serum caspase 3 levels are associated with early mortality in severe septic patients

详细信息    查看全文

• 作者：Leonardo Lorente ; MD ; PhD^a ; ^{lorentemartin@msn.com" class="auth_mail" title="E-mail the corresponding author} ; Marí ; a M. Martí ; n ; MD ; PhD^b ; ^{mar.martinvelasco@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; José ; Ferreres ; MD^c ; ^{ferreresj@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Jordi Solé ; -Violá ; n ; MD ; PhD^d ; ^{jsolvio@gobiernodecanarias.org" class="auth_mail" title="E-mail the corresponding author} ; Lorenzo Labarta ; MD^e ; ^{llabarta@salud.aragon.es" class="auth_mail" title="E-mail the corresponding author} ; Cé ; sar Dí ; az ; MD^f ; ^{incaicos@yahoo.es" class="auth_mail" title="E-mail the corresponding author} ; Alejandro Jimé ; nez ; PhD^g ; ^{ajimenezsosa@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Juan M. Borreguero-Leó ; n ; MD^h ; ^{jmborreguero@hotmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Caspase-3 ; Sepsis ; Mortality ; Outcome
• 刊名：Journal of Critical Care
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：34
• 期：Complete
• 页码：103-106
• 全文大小：283 K

文摘

Higher caspase 3 activity has been found in lymphocytes of septic patients than of healthy controls. However, an association between serum caspase 3 levels at moment of severe sepsis diagnosis and mortality in septic patients has not been previously demonstrated, and this was the main objective of the present study.

Methods

This is an observational study of 216 patients with severe sepsis in 6 Spanish intensive care units. We collected serum samples at moment of severe sepsis diagnosis to determine levels of caspase 3 and caspase-cleaved cytokeratin (CCCK) 18. End point was 30-day mortality.

Results

We found higher serum caspase 3 levels (P < .001) and caspase-cleaved cytokeratin 18 (P = .001) in nonsurvivors (n = 76) than in survivors (n = 140). Multiple binary logistic regression analysis showed that serum caspase 3 levels greater than 0.25 ng/mL were associated with 30-day mortality (odds ratio, 6.51; 95% confidence interval, 3.32-12.77; P < .001). Receiver operating characteristic analysis showed that the area under the curve to predict 30-day mortality for serum caspase 3 levels was 0.73 (95% confidence interval, 0.67-0.79; P < .001).

Conclusions

The major novel findings of our study were that there is an association between serum caspase 3 levels at moment of severe sepsis diagnosis and mortality in septic patients and that serum caspase 3 levels could be used as prognostic biomarker, and further studies are needed to corroborate these findings.