Association between septic patient mortality and blood survivin concentrations

Abstract

Objective: Survivin is a member of inhibitors of apoptosis proteins family. There are not data about the association between mortality of septic patients and blood survivin concentrations. Therefore, the objective of this study was to determine whether exist that association.

Design: Observational and prospective study.

Setting: Three Spanish Intensive Care Units.

Patients: Patients with sepsis or septic shock according to Sepsis-3 Consensus criteria.

Interventions: Serum survivin concentrations were determined at moment of sepsis diagnosis.

Main variable of interest: Mortality at 30 days.

Results: A total of 204 patients were included in the study, of which 75 (36.8%) died in the first 30 days. Lower age (p<0.001), serum lactic acid levels (p=0.001), rate of septic shock (p=0.001) and SOFA (p<0.001), and higher serum survivin levels (p=0.001) exhibited surviving (n=129) than non-surviving patients (n=75). We found in multiple logistic regression analysis an association between serum survivin concentrations and mortality independently of SOFA, lactic acid, age, INR, activated partial thromboplastin time (aPTT) and empiric antimicrobial treatment adequate (OR=0.968; 95% CI=0.946-0.990; p=0.005), and also independently of APACHE-II, lactic acid, platelet, INR, aPTT and empiric antimicrobial treatment adequate (OR=0.966; 95% CI=0.943-0.989; p=0.004).

Conclusions: There is an association between septic patient mortality and low blood survivin concentrations.

Keywords: Apoptosis; Mortalidad; Mortality; Outcome; Resultado; Sepsis; Survivin; Survivina.