Prognostic Value of Malondialdehyde Serum Levels in Severe Sepsis: A Multicenter Study

Lorente, L. ; Martín, M.M. ; Abreu-González, P. ; Domínguez-Rodríguez, A. ; Labarta, L. (Universidad de Zaragoza) ; Díaz, C. ; Solé-Violán, J. ; Ferreres, J. ; Borreguero-León, J.M. ; Jiménez, A. ; Morera-Fumero, A.

Resumen: Objective:
The oxidant/antioxidant state in septic patients has only been studied in small series. We wished to determine whether malondialdehyde (MDA) serum levels were associated with severity and 30-day mortality in a large series of patients with sepsis.
Methods:
We performed an observational, prospective, multicenter study in six Spanish Intensive Care Units. Serum levels of MDA were measured in a total of 228 patients (145 survivors and 83 non-survivors) with severe sepsis and 100 healthy controls.
Results:
Serum levels of MDA were higher in severe septic patients than in healthy controls. Non-surviving septic patients had higher MDA values than survivors. MDA serum levels were associated with severity markers (lactic acid, SOFA, APACHE-II) and coagulation indices. Regression analysis showed that MDA serum levels were associated with 30-day survival (Hazard ratio¿=¿1.05; 95% confidence interval¿=¿1.009–1.091; p¿=¿0.016). Receiver operating characteristic analysis showed that the area under curve of MDA serum levels to predict 30-day survival was 0.62 (95% CI¿=¿0.56–0.69; P¿=¿0.002). The risk of death in septic patients with MDA serum levels above 4.11 nmol/mL was higher than in patients with lower values (Hazard Ratio¿=¿2.43; 95% CI¿=¿1.49–3.94; p<0.001).
Conclusions:
The novel findings of our study on severe septic patients, to our knowledge the largest series providing data on the oxidative state, are that elevated MDA serum levels probably represent an unbalanced oxidant state and are related with poor prognosis in patients with severe sepsis.

Idioma: Inglés

DOI: 10.1371/journal.pone.0053741

Año: 2013

Publicado en: PLoS One 8, 1 (2013), e53741 [5 pp]
ISSN: 1932-6203

Factor impacto JCR: 3.534 (2013)

Categ. JCR: MULTIDISCIPLINARY SCIENCES rank: 8 / 56 = 0.143 (2013) - Q1 - T1

Financiación: info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI10-01572
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/I3SNS-INT-11-063

Tipo y forma: Article (Published version)

Área (Departamento): Medicina (Departamento de Medicina, Psiquiatría y Dermatología)