Sustained high serum malondialdehyde levels are associated with severity and mortality in septic patients View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2013-12-11

AUTHORS

Leonardo Lorente, María M Martín, Pedro Abreu-González, Alberto Domínguez-Rodriguez, Lorenzo Labarta, César Díaz, Jordi Solé-Violán, José Ferreres, Judith Cabrera, Jose Carlos Igeño, Alejandro Jiménez

ABSTRACT

IntroductionThere is a hyperoxidative state in sepsis. The objective of this study was to determine serum malondialdehyde (MDA) levels during the first week of follow up, whether such levels are associated with severity during the first week and whether non-surviving patients showed higher MDA levels than survivors during the first week.MethodsWe performed an observational, prospective, multicenter study in six Spanish Intensive Care Units. Serum levels of MDA were measured in 328 patients (215 survivors and 113 non-survivors) with severe sepsis at days one, four and eight of diagnosis, and in 100 healthy controls. The primary endpoint was 30-day mortality and the secondary endpoint was six -month mortality. The association between continuous variables was carried out using Spearman’s rank correlation coefficient. Cox regression analysis was applied to determine the independent contribution of serum MDA levels on the prediction of 30-day and 6-month mortality. Hazard ratio (HR) and 95% confidence intervals (CI) were calculated as measures of the clinical impact of the predictor variables.ResultsWe found higher serum MDA in septic patients at day one (p < 0.001), day four (p < 0.001) and day eight (p < 0.001) of diagnosis than in healthy controls. Serum MDA was lower in surviving than non-surviving septic patients at day one (p < 0.001), day four (p < 0.001) and day eight (p < 0.001). Serum MDA levels were positively correlated with lactic acid and SOFA during the first week. Finally, serum MDA levels were associated with 30-day mortality (HR = 1.05; 95% CI = 1.02-1.09; p = 0.005) and six-month mortality (hazard ratio (HR) = 1.05; 95% CI = 1.02-1.09; p = 0.003) after controlling for lactic acid levels, acute physiology and chronic health evaluation (APACHE)-II, diabetes mellitus, bloodstream infection and chronic renal failure.ConclusionsTo our knowledge, this is the largest series providing data on the oxidative state in septic patients to date. The novel finding is that high serum MDA levels sustained throughout the first week of follow up were associated with severity and mortality in septic patients. More... »

PAGES

r290

Journal

TITLE

Critical Care

ISSUE

6

VOLUME

17

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/cc13155

DOI

http://dx.doi.org/10.1186/cc13155

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1033347554

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24326199


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    "description": "IntroductionThere is a hyperoxidative state in sepsis. The objective of this study was to determine serum malondialdehyde (MDA) levels during the first week of follow up, whether such levels are associated with severity during the first week and whether non-surviving patients showed higher MDA levels than survivors during the first week.MethodsWe performed an observational, prospective, multicenter study in six Spanish Intensive Care Units. Serum levels of MDA were measured in 328 patients (215 survivors and 113 non-survivors) with severe sepsis at days one, four and eight of diagnosis, and in 100 healthy controls. The primary endpoint was 30-day mortality and the secondary endpoint was six -month mortality. The association between continuous variables was carried out using Spearman\u2019s rank correlation coefficient. Cox regression analysis was applied to determine the independent contribution of serum MDA levels on the prediction of 30-day and 6-month mortality. Hazard ratio (HR) and 95% confidence intervals (CI) were calculated as measures of the clinical impact of the predictor variables.ResultsWe found higher serum MDA in septic patients at day one (p\u2009<\u20090.001), day four (p\u2009<\u20090.001) and day eight (p\u2009<\u20090.001) of diagnosis than in healthy controls. Serum MDA was lower in surviving than non-surviving septic patients at day one (p\u2009<\u20090.001), day four (p\u2009<\u20090.001) and day eight (p\u2009<\u20090.001). Serum MDA levels were positively correlated with lactic acid and SOFA during the first week. Finally, serum MDA levels were associated with 30-day mortality (HR\u2009=\u20091.05; 95% CI\u2009=\u20091.02-1.09; p\u2009=\u20090.005) and six-month mortality (hazard ratio (HR)\u2009=\u20091.05; 95% CI\u2009=\u20091.02-1.09; p\u2009=\u20090.003) after controlling for lactic acid levels, acute physiology and chronic health evaluation (APACHE)-II, diabetes mellitus, bloodstream infection and chronic renal failure.ConclusionsTo our knowledge, this is the largest series providing data on the oxidative state in septic patients to date. The novel finding is that high serum MDA levels sustained throughout the first week of follow up were associated with severity and mortality in septic patients.", 
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30 schema:description IntroductionThere is a hyperoxidative state in sepsis. The objective of this study was to determine serum malondialdehyde (MDA) levels during the first week of follow up, whether such levels are associated with severity during the first week and whether non-surviving patients showed higher MDA levels than survivors during the first week.MethodsWe performed an observational, prospective, multicenter study in six Spanish Intensive Care Units. Serum levels of MDA were measured in 328 patients (215 survivors and 113 non-survivors) with severe sepsis at days one, four and eight of diagnosis, and in 100 healthy controls. The primary endpoint was 30-day mortality and the secondary endpoint was six -month mortality. The association between continuous variables was carried out using Spearman’s rank correlation coefficient. Cox regression analysis was applied to determine the independent contribution of serum MDA levels on the prediction of 30-day and 6-month mortality. Hazard ratio (HR) and 95% confidence intervals (CI) were calculated as measures of the clinical impact of the predictor variables.ResultsWe found higher serum MDA in septic patients at day one (p < 0.001), day four (p < 0.001) and day eight (p < 0.001) of diagnosis than in healthy controls. Serum MDA was lower in surviving than non-surviving septic patients at day one (p < 0.001), day four (p < 0.001) and day eight (p < 0.001). Serum MDA levels were positively correlated with lactic acid and SOFA during the first week. Finally, serum MDA levels were associated with 30-day mortality (HR = 1.05; 95% CI = 1.02-1.09; p = 0.005) and six-month mortality (hazard ratio (HR) = 1.05; 95% CI = 1.02-1.09; p = 0.003) after controlling for lactic acid levels, acute physiology and chronic health evaluation (APACHE)-II, diabetes mellitus, bloodstream infection and chronic renal failure.ConclusionsTo our knowledge, this is the largest series providing data on the oxidative state in septic patients to date. The novel finding is that high serum MDA levels sustained throughout the first week of follow up were associated with severity and mortality in septic patients.
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39 IntroductionThere
40 MDA
41 MDA levels
42 MethodsWe
43 ResultsWe
44 SOFA
45 Spanish intensive care units
46 Spearman's rank correlation coefficient
47 acid
48 acid levels
49 analysis
50 association
51 bloodstream infections
52 care unit
53 chronic renal failure
54 clinical impact
55 coefficient
56 confidence intervals
57 continuous variables
58 contribution
59 control
60 correlation coefficient
61 data
62 date
63 day eight
64 day four
65 day one
66 diabetes mellitus
67 diagnosis
68 eight
69 endpoint
70 evaluation
71 failure
72 findings
73 first week
74 follow
75 four
76 hazard ratio
77 health evaluation
78 healthy controls
79 high serum malondialdehyde levels
80 higher MDA levels
81 higher serum MDA levels
82 hyperoxidative state
83 impact
84 independent contribution
85 infection
86 intensive care unit
87 interval
88 knowledge
89 lactic acid
90 lactic acid levels
91 large series
92 levels
93 malondialdehyde levels
94 measures
95 mellitus
96 mortality
97 multicenter study
98 non-surviving patients
99 non-surviving septic patients
100 novel findings
101 objective
102 one
103 oxidative state
104 patients
105 physiology
106 prediction
107 predictor variables
108 primary endpoint
109 rank correlation coefficient
110 ratio
111 regression analysis
112 renal failure
113 secondary endpoints
114 sepsis
115 septic patients
116 series
117 serum MDA
118 serum MDA levels
119 serum levels
120 serum malondialdehyde levels
121 severe sepsis
122 severity
123 six-month mortality
124 state
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126 such levels
127 survivors
128 units
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