Non-survivor septic patients have persistently higher serum sCD40L levels than survivors

J Crit Care. 2017 Oct:41:177-182. doi: 10.1016/j.jcrc.2017.05.021. Epub 2017 May 24.

Abstract

Introduction: Soluble CD40 ligand (sCD40L) is a protein with proinflammatory and prothrombotic effects. Previously we found higher circulating sCD40L levels in non-survivor than in survivor patients at sepsis diagnosis. Now some questions arise such as how are serum sCD40L levels during the first week of severe sepsis?, is there an association between serum sCD40L levels during the first week and mortality?, and serum sCD40L levels during the first week could be used as sepsis mortality biomarker?. This study was developed to answer these asks.

Methods: Study from 6 Spanish Intensive Care Units with 291 severe septic patients. There were determined serum levels of sCD40L and tumor necrosis factor (TNF)-alpha during the first week. The end-point study was 30-day mortality.

Results: We found that serum sCD40L at days 1, 4, and 8 could predict mortality at 30days, and are associated with mortality.

Conclusions: The novel findings of our study were that there were higher serum sCD40L levels persistently during the first week in non-survivor than in survivor patients, that there is an association between serum sCD40L levels during the first week and sepsis mortality, and that serum sCD40L levels during the first week could be used as sepsis mortality biomarker.

Keywords: Mortality; Sepsis; sCD40L.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • CD40 Ligand / blood*
  • Female
  • Hospital Mortality*
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Prospective Studies
  • ROC Curve
  • Sepsis / blood*
  • Sepsis / mortality*
  • Survivors
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Biomarkers
  • Tumor Necrosis Factor-alpha
  • CD40 Ligand