Soluble RAGE as a severity marker in community acquired pneumonia associated sepsis
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- 作者：Rodrigo M Narvaez-Rivera (1)
Adrian Rendon (2)
Mario C Salinas-Carmona (3)
Adrian G Rosas-Taraco (3) - 关键词：SOFA score ; Soluble RAGE ; Severity markers ; Community ; acquired pneumonia ; Survival
- 刊名：BMC Infectious Diseases
- 出版年：2012
- 出版时间：December 2012
- 年：2012
- 卷：12
- 期：1
- 全文大小：211KB
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40. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2334/12/15/prepub - 作者单位：Rodrigo M Narvaez-Rivera (1)
Adrian Rendon (2)
Mario C Salinas-Carmona (3)
Adrian G Rosas-Taraco (3)
1. Department of Internal Medicine, Universidad Autonoma de Nuevo Leon, UANL, School of Medicine and University Hospital, Monterrey, Nuevo Leon, Mexico
2. CIPTIR (Centro de Investigacion, Prevencion y Tratamiento de Infecciones Respiratorias), Universidad Autonoma de Nuevo Leon, UANL, School of Medicine and University Hospital, Monterrey, Nuevo Leon, Mexico
3. Department of Immunology, Universidad Autonoma de Nuevo Leon, UANL, School of Medicine and University Hospital, Monterrey, Nuevo Leon, Mexico
文摘
Background Community-acquired pneumonia (CAP) is considered the most important cause of death from infectious disease in developed countries. Severity assessment scores partially address the difficulties in identifying high-risk patients. A lack of specific and valid pathophysiologic severity markers affect early and effective sepsis therapy. HMGB-1, sRAGE and RAGE have been involved in sepsis and their potential as severity markers has been proposed. The aim of this study was to evaluate HMGB-1, RAGE and sRAGE levels in patients with CAP-associated sepsis and determine their possible association with clinical outcome. Method We evaluated 33 patients with CAP-associated sepsis admitted to the emergency room and followed in the medical wards. Severity assessment scores (CURB-65, PSI, APACHE II, SOFA) and serologic markers (HMGB-1, RAGE, sRAGE) were evaluated on admission. Results Thirty patients with a diagnosis of CAP-associated sepsis were enrolled in the study within 24 hours after admission. Fourteen (46.6%) had pandemic (H1N1) influenza A virus, 2 (6.6%) had seasonal influenza A and 14 other diagnoses. Of the patients in the study group, 16 (53.3%) had a fatal outcome. ARDS was observed in 17 (56.6%) and a total of 22 patients had severe sepsis on admission (73%). The SOFA score showed the greatest difference between surviving and non-surviving groups (P = .003) with similar results in ARDS patients (P = .005). sRAGE levels tended to be higher in non-surviving (P = .058) and ARDS patients (P = .058). Logistic regression modeling demonstrated that SOFA (P = .013) and sRAGE (P = .05) were the only variables that modified the probability of a fatal outcome. Conclusion The association of elevated sRAGE with a fatal outcome suggests that it may have an independent causal effect in CAP. SOFA scores were the only clinical factor with the ability to identify surviving and ARDS patients.