IntroductionIn a previous study with 96 septic patients, we found that circulating platelets in 6-months surviving septic patients showed higher activity and quantity of cytochrome c oxidase (COX) normalized by citrate synthase (CS) activity at moment of severe sepsis diagnosis than non-surviving septic patients. The objective of this study was to estimate whether COX specific activity during the first week predicts 1-month sepsis survival in a larger cohort of patients.MethodsUsing a prospective, multicenter, observational study carried out in six Spanish intensive care units with 198 severe septic patients, we determined COX activity per proteins (COXact/Prot) in circulating platelets at day 1, 4 and 8 of the severe sepsis diagnosis. Endpoints were 1-month and 6-months mortality.ResultsSurvivor patients (n?=?130) showed higher COXact/Prot (P??0.30 mOD/min/mg at day 1 (P?=?0.002), 4 (P?=?0.006) and 8 (P?=?0.02) was associated independently with 1-month mortality. Area under the curve of COXact/Prot at day 1, 4 and 8 to predict 30-day survival were 0.70 (95% CI?=?0.63-0.76; P?
展开▼
机译：前言在对96名败血症患者进行的一项先前研究中，我们发现在严重脓毒症诊断时，存活的6个月败血症患者中的循环血小板显示较高的活性和通过柠檬酸合酶（CS）活性标准化的细胞色素C氧化酶（COX）量。尚存败血症的患者。这项研究的目的是评估第一周COX特异性活动是否可以预测较大人群的脓毒症生存期1个月。方法：采用前瞻性，多中心，观察性研究在西班牙的六个重症监护病房中对198名严重败血症患者进行了研究，我们在严重脓毒症诊断的第1、4和8天测定了循环血小板中每种蛋白质的COX活性（COXact / Prot）。终点为1个月和6个月死亡率。结果幸存者患者（n？=？130）在第1天显示较高的COXact / Prot（P？0.30 mOD / min / mg（P？=？0.002），4（P？ =？0.006）和8（P？=？0.02）与1个月死亡率独立相关，在第1、4和8天预测30天生存率的COXact / Prot曲线下面积为0.70（95％CI？ ＝ 0.63-0.76; P ＜＜ 0.001; 0.71（95％CI ＝＝ 0.64-0.77; P ＜＜ 0.001）和0.71（95％CI ＝＝ 0.64-0.78; P ＜＜ 0.001）。结论我们的新发现是脓毒症患者随访期间线粒体功能报告的最大数据，据我们所知，在脓毒症诊断时存活1个月的脓毒症患者血小板细胞色素氧化酶活性较高。并且在第一周比非幸存者更早，并且败血症诊断时和第一周的血小板细胞色素氧化酶活性可以用作生物标记，以预测败血症患者的临床结局。
展开▼
