Asociación del antígeno carbohidrato 125 con la mortalidad por sepsis en pacientes críticos / Association of carbohydrate 125 antigen with sepsis mortality in critical patients

IntroductionThe increased synthesis of CA125 in mesothelial cells is connected with pathophysiological processes, also present in sepsis, that link inflammation with systemic congestion. We propose to evaluate serum levels of this biomarker in patients with sepsis and to study its association with the severity and evolution of the disease.MethodsLongitudinal retrospective observational study, which included 126 patients admitted to an Intensive Care Unit with sepsis criteria. The main variables analyzed were: CA125 values for 7 days, the variation of its levels according to the source of infection (abdominal, pulmonary, nephrourinary and others), sepsis, septic shock, APACHE-II score and mortality.ResultsCA125 levels remained elevated throughout the study period. The abdominal focus presented higher mean levels of CA125 (62±55.5U/mL; P=.001) and were higher in non-survivors (77.2U/mL; interquartile range 35.9-118.5; P=.0273). CA125 levels>35U/mL throughout the weal had an independently effect on the evolution (relative risk [RR] 3.1; 95% confidence interval [CI] 1.6-6.2; P=.001) and the elevated mean value of CA125 was also associated with mortality (RR 1.004; 95% CI 1.001-1.005; P=.0001).ConclusionsSeptic patients presented high levels of CA125 on the study days, being higher in abdominal infections. In our study, serial determination of CA125 is a prognostic marker of mortality independent of age, origin of infection or severity. (AU)

IntroducciónLa síntesis aumentada de CA125 en las células mesoteliales se asocia a procesos fisiopatológicos presentes en la sepsis, que relacionan la inflamación con la congestión sistémica. Proponemos evaluar los niveles séricos de este biomarcador en la sepsis y estudiar su asociación con la gravedad y evolución de la enfermedad.MétodosEstudio observacional prospectivo longitudinal que incluyó a 126 pacientes que ingresaron en una unidad de cuidados intensivos con criterios de sepsis. Las variables principales analizadas fueron: valores de CA125 durante 7 días, foco causante de la infección (abdominal, pulmonar, nefrourinario y otros), sepsis, shock séptico, escala APACHE-II y mortalidad.ResultadosLos niveles de CA125 se mantuvieron elevados en el período de estudio. El foco abdominal presentó niveles medios de CA125 más elevados (62±55,5U/ml; p=0,001) y fueron superiores en los pacientes que fallecieron (77,2U/ml; rango intercuartil 35,9-118,5; p=0,0273). Los niveles de CA125>35U/ml durante toda la semana tuvieron un efecto sobre la evolución de forma independiente (riesgo relativo [RR] 3,1; intervalo de confianza [IC] 95% 1,6 a 6,2; p=0,001) y el valor medio elevado de CA125 también se asoció a la mortalidad (RR 1,004; IC 95% 1,001-1,005; p=0,0001).ConclusionesLos pacientes sépticos presentaron unos niveles elevados de CA125 en los días de estudio, siendo superiores en infecciones de foco abdominal. En nuestro estudio, la determinación seriada de CA125 es un marcador pronóstico de mortalidad independiente de la edad, el origen de la infección o la gravedad. (AU)

Association of carbohydrate 125 antigen with sepsis mortality in critical patients. / Asociación del antígeno carbohidrato 125 con la mortalidad por sepsis en pacientes críticos.

INTRODUCTION: The increased synthesis of CA125 in mesothelial cells is connected with pathophysiological processes, also present in sepsis, that link inflammation with systemic congestion. We propose to evaluate serum levels of this biomarker in patients with sepsis and to study its association with the severity and evolution of the disease. METHODS: Longitudinal retrospective observational study, which included 126 patients admitted to an Intensive Care Unit with sepsis criteria. The main variables analyzed were: CA125 values for 7 days, the variation of its levels according to the source of infection (abdominal, pulmonary, nephrourinary and others), sepsis, septic shock, APACHE-II score and mortality. RESULTS: CA125 levels remained elevated throughout the study period. The abdominal focus presented higher mean levels of CA125 (62±55.5U/mL; P=.001) and were higher in non-survivors (77.2U/mL; interquartile range 35.9-118.5; P=.0273). CA125 levels>35U/mL throughout the weal had an independently effect on the evolution (relative risk [RR] 3.1; 95% confidence interval [CI] 1.6-6.2; P=.001) and the elevated mean value of CA125 was also associated with mortality (RR 1.004; 95% CI 1.001-1.005; P=.0001). CONCLUSIONS: Septic patients presented high levels of CA125 on the study days, being higher in abdominal infections. In our study, serial determination of CA125 is a prognostic marker of mortality independent of age, origin of infection or severity.