Soluble RAGE as a severity marker in community acquired pneumonia associated sepsis

BMC Infectious Diseases

Adrian G Rosas-Taraco³  Mario C Salinas-Carmona³  Adrian Rendon¹  Rodrigo M Narvaez-Rivera² 

[1] Universidad Autonoma de Nuevo Leon, UANL, School of Medicine and University Hospital, CIPTIR (Centro de Investigacion, Prevencion y Tratamiento de Infecciones Respiratorias). Monterrey, Nuevo Leon, Mexico;Universidad Autonoma de Nuevo Leon, UANL, School of Medicine and University Hospital, Department of Internal Medicine. Monterrey Nuevo Leon. Mexico;Universidad Autonoma de Nuevo Leon, UANL, School of Medicine and University Hospital, Department of Immunology. Monterrey Nuevo Leon. Mexico

关键词: Survival;    Community-acquired pneumonia;    Severity markers;    Soluble RAGE;    SOFA score;   

Others  :  1175475
DOI  :  10.1186/1471-2334-12-15

 received in 2011-02-03, accepted in 2012-01-20,  发布年份 2012

【 摘 要 】

Background

Community-acquired pneumonia (CAP) is considered the most important cause of death from infectious disease in developed countries. Severity assessment scores partially address the difficulties in identifying high-risk patients. A lack of specific and valid pathophysiologic severity markers affect early and effective sepsis therapy. HMGB-1, sRAGE and RAGE have been involved in sepsis and their potential as severity markers has been proposed. The aim of this study was to evaluate HMGB-1, RAGE and sRAGE levels in patients with CAP-associated sepsis and determine their possible association with clinical outcome.

Method

We evaluated 33 patients with CAP-associated sepsis admitted to the emergency room and followed in the medical wards. Severity assessment scores (CURB-65, PSI, APACHE II, SOFA) and serologic markers (HMGB-1, RAGE, sRAGE) were evaluated on admission.

Results

Thirty patients with a diagnosis of CAP-associated sepsis were enrolled in the study within 24 hours after admission. Fourteen (46.6%) had pandemic (H1N1) influenza A virus, 2 (6.6%) had seasonal influenza A and 14 other diagnoses. Of the patients in the study group, 16 (53.3%) had a fatal outcome. ARDS was observed in 17 (56.6%) and a total of 22 patients had severe sepsis on admission (73%). The SOFA score showed the greatest difference between surviving and non-surviving groups (P = .003) with similar results in ARDS patients (P = .005). sRAGE levels tended to be higher in non-surviving (P = .058) and ARDS patients (P = .058). Logistic regression modeling demonstrated that SOFA (P = .013) and sRAGE (P = .05) were the only variables that modified the probability of a fatal outcome.

Conclusion

The association of elevated sRAGE with a fatal outcome suggests that it may have an independent causal effect in CAP. SOFA scores were the only clinical factor with the ability to identify surviving and ARDS patients.

【 授权许可】

   
2012 Narvaez-Rivera et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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