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Vol. 47. Issue 2.
Pages 84-89 (February 2023)
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Vol. 47. Issue 2.
Pages 84-89 (February 2023)
Original article
Association between septic patient mortality and blood survivin concentrations
Asociación entre la mortalidad de pacientes sépticos y las concentraciones sanguíneas de survivina
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L. Lorentea,
Corresponding author
lorentemartin@msn.com

Corresponding author.
, M.M. Martínb, R. Ortiz-Lópezc, A. Pérez-Cejasd, C. Ferrer-Moured, A. Jiméneze, A.F. González-Riverod
a Intensive Care Unit, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain
b Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Santa Cruz Tenerife, Spain
c Intensive Care Unit, Hospital General de La Palma, Breña Alta, La Palma, Spain
d Laboratory Department, Hospital Universitario de Canarias, Tenerife, Spain
e Research Unit, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain
Article information
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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
Survivin
Sepsis
Mortality
Outcome
Abbreviations:
APACHE
aPTT
COPD
FIO2
INR
ICU
PaO2
SOFA
Resumen
Objetivo

Survivina es un miembro de la familia de proteínas inhibidoras de apoptosis. No existen datos sobre la asociación entre la mortalidad de los pacientes sépticos y las concentraciones de survivina en sangre. Por tanto, el objetivo de este estudio fue determinar si existe esa asociación.

Diseño

Estudio observacional y prospectivo.

Ámbito

Tres Unidades de Cuidados Intensivos españolas.

Pacientes

Pacientes con sepsis o shock séptico según criterios del Consenso Sepsis-3.

Intervenciones

Se determinaron las concentraciones séricas de survivina en el momento del diagnóstico de la sepsis.

Variable de interés principal

Mortalidad a los 30 días.

Resultados

Un total de 204 pacientes se incluyeron en el estudio, 75 (36,8%) de los cuales fallecieron en los primeros 30 días. Menor edad (p<0,001), niveles séricos de ácido láctico (p=0,001), tasa de shock séptico (p=0,001) y SOFA (p<0,001), y mayores niveles de survivina en suero (p=0,001) exhibieron los pacientes supervivientes (n=129) en comparación con los fallecidos (n=75). El análisis de regresión logística múltiple mostró una asociación entre las concentraciones séricas de survivina y la mortalidad independientemente del SOFA, ácido láctico, edad, INR, tiempo de tromboplastina parcial activada (aPTT) y tratamiento antimicrobiano empírico adecuado (OR=0,968; IC 95%=0,946-0,990; p=0,005), y también independientemente del APACHE-II, ácido láctico, plaquetas, INR, aPTT y tratamiento antimicrobiano empírico adecuado (OR=0,966; IC 95%=0,943-0,989; p=0,004).

Conclusiones

Existe una asociación entre la mortalidad de los pacientes sépticos y las concentraciones bajas de survivina en sangre.

Palabras clave:
Apoptosis
Survivina
Sepsis
Mortalidad
Resultado

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