Blood caspase-8 concentrations and mortality among septic patients

L Lorente; M M Martín; R Ortiz-López; A F González-Rivero; A Pérez-Cejas; M Martín; V Gonzalez; A Pérez; M Rodin; A Jiménez

doi:10.1016/j.medin.2020.06.016

Blood caspase-8 concentrations and mortality among septic patients

Med Intensiva (Engl Ed). 2020 Aug 22:S0210-5691(20)30246-1. doi: 10.1016/j.medin.2020.06.016. Online ahead of print.

[Article in English, Spanish]

Authors

L Lorente¹, M M Martín², R Ortiz-López³, A F González-Rivero⁴, A Pérez-Cejas⁵, M Martín⁶, V Gonzalez⁶, A Pérez⁶, M Rodin⁶, A Jiménez⁷

Affiliations

¹ Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n., La Laguna 38320, Tenerife, Spain. Electronic address: lorentemartin@msn.com.
² Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Crta Rosario s/n., Santa Cruz Tenerife 38010, Spain.
³ Intensive Care Unit, Hospital General de La Palma, Buenavista de Arriba s/n, Breña Alta, La Palma 38713, Spain.
⁴ Laboratory Department, Hospital Universitario de Canarias, Ofra, s/n., La Laguna 38320, Santa Cruz de Tenerife, Spain.
⁵ Laboratory Department, Hospital Universitario de Canarias, Ofra, s/n., La Laguna 38320, Tenerife, Spain.
⁶ Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n., La Laguna, Santa Cruz de Tenerife 38320, Spain.
⁷ Research Unit, Hospital Universitario de Canarias, Ofra, s/n., La Laguna 38320, Tenerife, Spain.

PMID: 32843190
DOI: 10.1016/j.medin.2020.06.016

Abstract

Objective: No data are available on blood caspase-8 concentrations (the initiator caspase in the extrinsic apoptosis pathway) in septic patients. The present study thus describes the blood caspase-8 concentrations in survivors and non-survivors, and examines the possible association between blood caspase-8 concentrations and mortality in septic patients.

Design: A prospective observational study was carried out.

Setting: Three Spanish Intensive Care Units.

Patients: Septic patients.

Interventions: Serum caspase-8 concentrations were determined at the diagnosis of sepsis.

Main variable of interest: Mortality after 30 days.

Results: Patients not surviving at day 30 (n=81) compared to surviving patients (n=140) showed higher serum caspase-8 levels (p<0.001). Multiple logistic regression analysis found an association between serum caspase-8 levels>43.5ng/ml and mortality (OR=3.306; 95%CI=1.619-6.753; p=0.001). The area under the curve (AUC) for mortality predicted by serum caspase-8 levels was 67% (95% CI=60-73%; p<0.001).

Conclusions: The novel findings of our study were that blood caspase-8 concentrations are higher in non-survivors than in survivors, and that there is an association between blood caspase-8 concentrations and mortality in septic patients.

Keywords: Apoptosis; Caspasa-8; Caspase-8; Mortalidad; Mortality; Outcome; Resultado; Sepsis.