Introduction

Scarce data on Fas, one of the main receptors that activates the apoptosis extrinsic pathway, in septic patients exists. Higher blood soluble Fas (sFas) concentrations in non-survivor septic patients compared with survivors have been found in small studies; however, the association of blood sFas concentrations with mortality controlling for sepsis severity has not been stablished due to this small sample size in those studies. Thus, our main objective study was to determine whether an association between blood sFas concentrations and sepsis mortality controlling for sepsis severity exists.

Methods

We included septic patients in this observational and prospective study carried out in three Spanish Intensive Care Units. We obtained serum samples at sepsis diagnosis sepsis for sFas levels determination.

Results

Thirty-day non-surviving patients (n = 85) compared to surviving patients (n = 151) had higher serum sFas levels (p < 0.001). We found in multiple logistic regression analysis an association of serum sFas levels with mortality controlling for age and SOFA (OR = 1.004; 95% CI = 1.002–1.006; p < 0.001), and for age and APACHE-II (OR = 1.004; 95% CI = 1.002–1.006; p < 0.001). Serum sFas levels showed and area under the curve for mortality prediction of 71% (95% CI = 65–71%; p < 0.001). Kaplan–Meier analysis showed higher mortality rate in patients with serum sFas levels > 83.5 ng/mL (Hazard ratio = 3.2; 95% CI = 2.1–5.0; p < 0.001).

Conclusions

That an association between blood sFas concentrations and sepsis mortality controlling for sepsis severity exists was our main new finding study.

中文翻译：

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脓毒症患者血清可溶性Fas浓度与死亡率的关系

 介绍

Fas 是脓毒症患者中激活细胞凋亡外在途径的主要受体之一，但关于 Fas 的数据很少。小型研究发现，与幸存者相比，非幸存者脓毒症患者的血液可溶性 Fas (sFas) 浓度更高；然而，由于这些研究中的样本量较小，血液 sFas 浓度与控制脓毒症严重程度的死亡率之间的关联尚未确定。因此，我们的主要目标研究是确定血液 sFas 浓度与控制脓毒症严重程度的脓毒症死亡率之间是否存在关联。

 方法

我们在西班牙三个重症监护室进行的这项观察性和前瞻性研究中纳入了脓毒症患者。我们在脓毒症诊断脓毒症时获取血清样本用于测定 sFas 水平。

 结果

与存活患者 ( n = 151) 相比，30 天未存活患者 ( n = 85) 的血清 sFas 水平较高 ( p < 0.001)。我们在多元逻辑回归分析中发现，在控制年龄和 SOFA 的情况下（OR = 1.004；95% CI = 1.002–1.006； p < 0.001）以及年龄和 APACHE-II 的情况下（OR = 1.004；95% CI = 1.002–1.006；p < 0.001），血清 sFas 水平与死亡率存在关联。 95% CI = 1.002–1.006； p < 0.001）。血清 sFas 水平显示死亡率预测曲线下面积为 71%（95% CI = 65–71%； p < 0.001）。 Kaplan-Meier 分析显示，血清 sFas 水平 > 83.5 ng/mL 的患者死亡率较高（风险比 = 3.2；95% CI = 2.1–5.0； p < 0.001）。

 结论

我们主要的新发现研究表明，血液 sFas 浓度与控制脓毒症严重程度的脓毒症死亡率之间存在关联。