Relationship of Plasma Gelsolin Levels to Outcomes in Critically Ill Surgical Patients

In Brief Objective: To examine the relationship between plasma gelsolin levels and mortality following surgery or trauma. Background: Few simple predictive diagnostic tests are available to predict mortality following surgery or trauma. We hypothesize that plasma concentrations of gelsolin, a protein that responds to injured tissue, might be a predictor of patient outcomes. Methods: We conducted a prospective, observational study in the surgical intensive units (ICU) at a tertiary care teaching hospital. A total of 31 patients were enrolled in the study. Chart abstraction was used to gather data about patient demographics, clinical characteristics, and clinical outcomes. Plasma gelsolin concentrations were assessed serially on day 0 through day 5. Results: Low plasma gelsolin levels were associated with increased risk of death occurring in the ICU. Plasma gelsolin levels lower than 61 mg/L predicted longer ICU stay, prolonged ventilator dependence, and increased overall in-hospital mortality. Conclusion: Plasma gelsolin is a potential prognostic biomarker for critically ill surgical patients. Plasma gelsolin replacement may have therapeutic application. Plasma gelsolin is an important protein in maintaining normal physiology in organisms. Depletion of plasma gelsolin in setting of injury reflects the severity of injury. We show that plasma gelsolin levels can be used as a biomarker to identify critically ill surgical patients at increased risk of poor clinical outcomes.