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journal article Open Access Feb 19, 2020

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

M Martin-Fernandez L M Vaquero-Roncero R Almansa E Gómez-Sánchez S Martin 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 Lopez ORCID 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 ORCID C Aldecoa M Heredia-Rodríguez
BJS Open Vol. 4 No. 3 pp. 524-534 · Oxford University Press (OUP)
View at Publisher Save 10.1002/bjs5.50265
Abstract
AbstractBackgroundStratification 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.MethodsLevels 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.ResultsThere 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).ConclusionMR-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.
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35
Citations
46
References
Details
Published
Feb 19, 2020
Vol/Issue
4(3)
Pages
524-534
License
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Authors
M
M Martin-Fernandez

Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca (IBSAL) , Salamanca, Spain; Research Unit, Hospital Clínico Universitario de Valladolid , Valladolid, Spain

L
L M Vaquero-Roncero

Anaesthesiology and Reanimation Service, Hospital Universitario de Salamanca , Salamanca, Spain

R
R Almansa

Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca (IBSAL) , Salamanca, Spain; Research Unit, Hospital Clínico Universitario de Valladolid , Valladolid, Spain; Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Instituto de Salud Carlos III , Madrid, Spain

E
E Gómez-Sánchez

Group for Biomedical Research in Critical Care (BioCritic), Anaesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid , Valladolid, Spain

S
S Martin

Anaesthesiology and Reanimation Service, Hospital Universitario Río Hortega , Valladolid, Spain

E
E Tamayo

Group for Biomedical Research in Critical Care (BioCritic), Anaesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid , Valladolid, Spain

M
M C Esteban-Velasco

Department of General and Gastrointestinal Surgery, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL) and Universidad de Salamanca , Salamanca, Spain

P
P Ruiz-Granado

Group for Biomedical Research in Critical Care (BioCritic), Anaesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid , Valladolid, Spain

M
M Aragón

Group for Biomedical Research in Critical Care (BioCritic), Anaesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid , Valladolid, Spain

D
D Calvo

Clinical Analysis Service, Hospital Clínico Universitario de Valladolid , Valladolid, Spain

J
J Rico-Feijoo

Anaesthesiology and Reanimation Service, Hospital Universitario Río Hortega , Valladolid, Spain

A
A Ortega

Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca (IBSAL) , Salamanca, Spain; Research Unit, Hospital Clínico Universitario de Valladolid , Valladolid, Spain

E
E Gómez-Pesquera

Group for Biomedical Research in Critical Care (BioCritic), Anaesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid , Valladolid, Spain

M
M Lorenzo-López

Group for Biomedical Research in Critical Care (BioCritic), Anaesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid , Valladolid, Spain

J
J Lopez

Department of General and Gastrointestinal Surgery, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL) and Universidad de Salamanca , Salamanca, Spain

C
C Doncel

Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca (IBSAL) , Salamanca, Spain; Research Unit, Hospital Clínico Universitario de Valladolid , Valladolid, Spain

C
C González-Sanchez

Department of General and Gastrointestinal Surgery, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL) and Universidad de Salamanca , Salamanca, Spain

D
D Álvarez

Anaesthesiology and Reanimation Service, Hospital Universitario de Salamanca , Salamanca, Spain

E
E Zarca

Clinical Analysis Service, Hospital Clínico Universitario de Valladolid , Valladolid, Spain

A
A Ríos-Llorente

Anaesthesiology and Reanimation Service, Hospital Universitario de Salamanca , Salamanca, Spain

A
A Diaz-Alvarez

Anaesthesiology and Reanimation Service, Hospital Universitario de Salamanca , Salamanca, Spain

E
E Sanchez-Barrado

Anaesthesiology and Reanimation Service, Hospital Universitario de Salamanca , Salamanca, Spain

D
D Andaluz-Ojeda

Intensive Care Medicine Service, Hospital Clínico Universitario de Valladolid , Valladolid, Spain

J
J M Calvo-Vecino

Anaesthesiology and Reanimation Service, Hospital Universitario de Salamanca , Salamanca, Spain

L
L Muñoz-Bellvís

Department of General and Gastrointestinal Surgery, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL) and Universidad de Salamanca , Salamanca, Spain; Biomedical Research Networking Centre on Cancer (CIBERONC) , Madrid, Spain

J
J I Gomez-Herreras

Group for Biomedical Research in Critical Care (BioCritic), Anaesthesiology and Reanimation Service, Hospital Clínico Universitario de Valladolid , Valladolid, Spain

C
C Abad-Molina

Microbiology and Immunology Service, Hospital Clínico Universitario de Valladolid , Valladolid, Spain

J
J F Bermejo-Martin

Group for Biomedical Research in Sepsis (BioSepsis), Instituto de Investigación Biomédica de Salamanca (IBSAL) , Salamanca, Spain; Research Unit, Hospital Clínico Universitario de Valladolid , Valladolid, Spain; Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Instituto de Salud Carlos III , Madrid, Spain

C
C Aldecoa

Anaesthesiology and Reanimation Service, Hospital Universitario Río Hortega , Valladolid, Spain

M
M Heredia-Rodríguez

Anaesthesiology and Reanimation Service, Hospital Universitario de Salamanca , Salamanca, Spain

Funding
European Union
Instituto de Salud Carlos III Award: PI15/01451
Cite This Article
M Martin-Fernandez, L M Vaquero-Roncero, R Almansa, et al. (2020). Endothelial dysfunction is an early indicator of sepsis and neutrophil degranulation of septic shock in surgical patients. BJS Open, 4(3), 524-534. https://doi.org/10.1002/bjs5.50265
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