Leonardo Lorente1, María M Martín2, Teresa Almeida3, Mariano Hernández4, José Ferreres5, Jordi Solé-Violán6, Lorenzo Labarta7, César Díaz8, Alejandro Jiménez9. 1. Intensive Care Unit, Hospital Universitario de Canarias, Ofra, La Laguna, Tenerife, Spain. Electronic address: lorentemartin@msn.com. 2. Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Santa Cruz, Tenerife, Spain. Electronic address: mar.martinvelasco@gmail.com. 3. Unidad de Genética, Instituto de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, La Laguna, Tenerife, Spain. Electronic address: tacosalm@ull.edu.es. 4. Unidad de Genética, Instituto de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, La Laguna, Tenerife, Spain. Electronic address: mnhdez@ull.edu.es. 5. Intensive Care Unit, Hospital Clínico Universitario de Valencia, Valencia, Spain. Electronic address: ferreresj@gmail.com. 6. Intensive Care Unit, Hospital Universitario Dr. Negrín, Barranco de la Ballena, Las Palmas de Gran Canaria, Spain. Electronic address: jsolvio@gobiernodecanarias.org. 7. Intensive Care Unit, Hospital San Jorge de Huesca, Huesca, Spain. Electronic address: llabarta@salud.aragon.es. 8. Intensive Care Unit, Hospital Insular, Las Palmas de Gran Canaria, Spain. Electronic address: incaicos@yahoo.es. 9. Research Unit, Hospital Universitario de Canarias, Ofra, La Laguna, Tenerife, Spain. Electronic address: ajimenezsosa@gmail.com.
Abstract
BACKGROUND: Substance P (SP) is a peptide of the tachykinins family involved in the inflammatory response. Circulating SP levels have been assessed in septic patients in 2 previous studies with a small number of subjects (61 and 42 patients, respectively), and there were no significant differences in SP levels at the moment of sepsis diagnosis between surviving and nonsurviving patients. The main goal of this study was to determine a possible relationship between serum SP levels and patient outcome in the largest cohort of severe septic patients analyzed so far. METHODS: We performed an observational, prospective, multicenter study in 6 Spanish intensive care units. Serum SP levels were measured at the moment of severe sepsis diagnosis in 238 patients. The end point of the study was 30-day mortality. RESULTS: We found that surviving septic patients (n = 153) showed higher serum SP levels than did nonsurvivors (n = 85). Multiple logistic regression analysis showed that serum SP levels higher than 350 pg/mL were associated with survival at 30 days (odds ratio, 0.43; 95% confidence interval, 0.24-0.77; P = .005) after controlling for serum lactic acid levels and Sepsis-related Organ Failure Assessment score. CONCLUSIONS: The major new finding of our study was that serum SP levels were associated with mortality in severe septic patients.
BACKGROUND:Substance P (SP) is a peptide of the tachykinins family involved in the inflammatory response. Circulating SP levels have been assessed in septicpatients in 2 previous studies with a small number of subjects (61 and 42 patients, respectively), and there were no significant differences in SP levels at the moment of sepsis diagnosis between surviving and nonsurviving patients. The main goal of this study was to determine a possible relationship between serum SP levels and patient outcome in the largest cohort of severe septicpatients analyzed so far. METHODS: We performed an observational, prospective, multicenter study in 6 Spanish intensive care units. Serum SP levels were measured at the moment of severe sepsis diagnosis in 238 patients. The end point of the study was 30-day mortality. RESULTS: We found that surviving septicpatients (n = 153) showed higher serum SP levels than did nonsurvivors (n = 85). Multiple logistic regression analysis showed that serum SP levels higher than 350 pg/mL were associated with survival at 30 days (odds ratio, 0.43; 95% confidence interval, 0.24-0.77; P = .005) after controlling for serum lactic acid levels and Sepsis-related Organ Failure Assessment score. CONCLUSIONS: The major new finding of our study was that serum SP levels were associated with mortality in severe septicpatients.
Authors: Juan R Mella; Evan Chiswick; David Stepien; Rituparna Moitra; Elizabeth R Duffy; Arthur Stucchi; Daniel Remick Journal: Crit Care Med Date: 2017-02 Impact factor: 7.598