Association between serum substance P levels and mortality in patients with severe sepsis

• Published in: Journal of critical care Vol. 30; no. 5; pp. 924 - 928
• Main Authors: Lorente, Leonardo, MD, PhD, Martín, María M., MD, PhD, Almeida, Teresa, MD, PhD, Hernández, Mariano, MD, PhD, Ferreres, José, MD, Solé-Violán, Jordi, MD, PhD, Labarta, Lorenzo, MD, Díaz, César, MD, Jiménez, Alejandro, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2015; Elsevier Limited
• Subjects: Acids; Aged; Biomarkers - blood; Cardiovascular disease; Chronic obstructive pulmonary disease; Critical Care; Diabetes; Female; Humans; Infections; Inflammation; Intensive Care Units; Kaplan-Meier Estimate; Lactic Acid - metabolism; Male; Middle Aged; Mortality; Odds Ratio; Organ Dysfunction Scores; Outcome; Prognosis; Prospective Studies; Sepsis; Sepsis - blood; Sepsis - mortality; Substance P; Substance P - metabolism; Variables; Spain; Sepsis; Substance P; Mortality; Outcome
• DOI: 10.1016/j.jcrc.2015.05.012
• EISSN: 1557-8615
• ISSN: 0883-9441

Abstract Background Substance P (SP) is a peptide of the tachykinins family involved in the inflammatory response. Circulating SP levels have been assessed in septic patients in 2 previous studies with a small number of subjects (61 and 42 patients, respectively), and there were no significant differences in SP levels at the moment of sepsis diagnosis between surviving and nonsurviving patients. The main goal of this study was to determine a possible relationship between serum SP levels and patient outcome in the largest cohort of severe septic patients analyzed so far. Methods We performed an observational, prospective, multicenter study in 6 Spanish intensive care units. Serum SP levels were measured at the moment of severe sepsis diagnosis in 238 patients. The end point of the study was 30-day mortality. Results We found that surviving septic patients (n = 153) showed higher serum SP levels than did nonsurvivors (n = 85). Multiple logistic regression analysis showed that serum SP levels higher than 350 pg/mL were associated with survival at 30 days (odds ratio, 0.43; 95% confidence interval, 0.24-0.77; P = .005) after controlling for serum lactic acid levels and Sepsis-related Organ Failure Assessment score. Conclusions The major new finding of our study was that serum SP levels were associated with mortality in severe septic patients.