Detectable A Disintegrin and Metalloproteinase With Thrombospondin Motifs-1 in Serum Is Associated With Adverse Outcome in Pediatric Sepsis.



Boeddha, Navin P, Driessen, Gertjan J, Hagedoorn, Nienke N ORCID: 0000-0001-9237-4904, Kohlfuerst, Daniela S, Hoggart, Clive J, van Rijswijk, Angelique L, Ekinci, Ebru, Priem, Debby, Schlapbach, Luregn J ORCID: 0000-0003-2281-2598, Herberg, Jethro A
et al (show 13 more authors) (2021) Detectable A Disintegrin and Metalloproteinase With Thrombospondin Motifs-1 in Serum Is Associated With Adverse Outcome in Pediatric Sepsis. Critical care explorations, 3 (11). e0569 - ?.

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Abstract

<h4>Importance</h4>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.<h4>Objectives</h4>To study A Disintegrin and Metalloproteinase with Thrombospondin Motifs-1 protein level in pediatric sepsis and to study the association with outcome.<h4>Design</h4>Data from two prospective cohort studies.<h4>Setting and participants</h4>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).<h4>Main outcomes and measures</h4>Primary outcome measure was mortality. Secondary outcome measures were PICU-free days at day 28 and hospital length of stay.<h4>Results</h4>In cohort 1 (<i>n</i> = 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; <i>p</i> = 0.02) and at t = 24 hours (2/3 [67%] and 3/37 [8%], respectively; <i>p</i> = 0.04). In cohort 2 (<i>n</i> = 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; <i>p</i> = 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; <i>p</i> = 0.003), which was mostly attributable to patients with <i>Neisseria meningitidis</i>.<h4>Conclusions and relevance</h4>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.

Item Type: Article
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 13 Jun 2022 08:29
Last Modified: 07 Jul 2022 22:11
DOI: 10.1097/cce.0000000000000569
URI: https://livrepository.liverpool.ac.uk/id/eprint/3156235