Detectable a disintegrin and metalloproteinase with thrombospondin motifs-1 in serum is associated with adverse outcome in pediatric sepsis.
Author(s)
Type
Journal Article
Abstract
IMPORTANCE: A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 is hypothesized to play a role in the pathogenesis of invasive infection, but studies in sepsis are lacking. OBJECTIVES: To study A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 protein level in pediatric sepsis and to study the association with outcome. DESIGN: Data from two prospective cohort studies. SETTING AND PARTICIPANTS: Cohort 1 is from a single-center study involving children admitted to PICU with meningococcal sepsis (samples obtained at three time points). Cohort 2 includes patients from a multicenter study involving children admitted to the hospital with invasive bacterial infections of differing etiologies (samples obtained within 48 hr after hospital admission). MAIN OUTCOMES AND MEASURES: Primary outcome measure was mortality. Secondary outcome measures were PICU-free days at day 28 and hospital length of stay. RESULTS: In cohort 1 (n = 59), nonsurvivors more frequently had A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 levels above the detection limit than survivors at admission to PICU (8/11 [73%] and 6/23 [26%], respectively; p = 0.02) and at t = 24 hours (2/3 [67%] and 3/37 [8%], respectively; p = 0.04). In cohort 2 (n = 240), A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 levels in patients within 48 hours after hospital admission were more frequently above the detection limit than in healthy controls (110/240 [46%] and 14/64 [22%], respectively; p = 0.001). Nonsurvivors more often had detectable A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 levels than survivors (16/21 [76%] and 94/219 [43%], respectively; p = 0.003), which was mostly attributable to patients with Neisseria meningitidis. CONCLUSIONS AND RELEVANCE: In children with bacterial infection, detection of A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 within 48 hours after hospital admission is associated with death, particularly in meningococcal sepsis. Future studies should confirm the prognostic value of A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 and should study pathophysiologic mechanisms.
Date Issued
2021-11
Online Publication Date
2022-08-05T13:36:37Z
Date Acceptance
2021-11-01
ISSN
2639-8028
Publisher
Lippincott, Williams & Wilkins
Start Page
1
End Page
12
Journal / Book Title
Critical Care Explorations
Volume
3
Issue
11
Copyright Statement
© 2021 The Authors.
Published by Wolters Kluwer Health,
Inc. on behalf of the Society of Critical
Care Medicine. This is an open-access
article distributed under the terms of
the Creative Commons AttributionNon Commercial-No Derivatives
License 4.0 (CC BY-NC-ND), where it
is permissible to download and share
the work provided it is properly cited.
The work cannot be changed in any
way or used commercially without
permission from the journal.
Published by Wolters Kluwer Health,
Inc. on behalf of the Society of Critical
Care Medicine. This is an open-access
article distributed under the terms of
the Creative Commons AttributionNon Commercial-No Derivatives
License 4.0 (CC BY-NC-ND), where it
is permissible to download and share
the work provided it is properly cited.
The work cannot be changed in any
way or used commercially without
permission from the journal.
Sponsor
European Commission
Identifier
https://journals.lww.com/ccejournal/Fulltext/2021/11000/Detectable_A_Disintegrin_and_Metalloproteinase.12.aspx
https://www.ncbi.nlm.nih.gov/pubmed/34765980
Grant Number
279185
Subjects
A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 protein
bacterial infections
biomarkers
inflammation
mortality
sepsis
A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 protein
bacterial infections
biomarkers
inflammation
mortality
sepsis
Publication Status
Published
Country
United States
Date Publish Online
2021-11-01