Key result
Plasma angiopoietin-1 levels below the median value independently predicted in-hospital mortality in patients with severe sepsis (HR 2.57).
Cohort (n=96)
No
Persistently decreased plasma Angiopoietin-1 levels are independently associated with the development of multiple organ dysfunction syndrome and in-hospital mortality in patients with severe sepsis.
Answers are grounded in this paper and cite their sources.
Low angiopoietin-1 levels may aid sepsis risk stratification; hypothesis-generating for biomarker use and leaves open therapeutic implications.
To determine plasma concentrations of angiopoietin (Ang)-1, Ang-2, Tie-2, and vascular endothelial growth factor (VEGF) in patients with sepsis-induced multiple organ dysfunction syndrome (MODS) and determine their association with mortality.The study prospectively recruited 96 consecutive patients with severe sepsis in a l intensive care unit of a tertiary hospital. Plasma Ang-1, Ang-2, Tie-2, and VEGF levels and MODS were determined in patients on days 1, 3, and 7 of sepsis. Univariate and Cox proportional hazards analysis were performed to develop a prognostic model.Days 1, 3, and 7 plasma Ang-1 concentrations were persistently decreased in MODS patients than in non-MODS patients (day1: 4.0 ± 0.5 vs 8.0 ± 0.5 ng/mL, P < 0.0001; day 3, 3.2 ± 0.6 vs 7.3 ± 0.5 ng/mL, P < 0.0001, day 7, 2.8 ± 0.6 vs 10.4 ± 0.7 ng/mL, P < 0.0001). In patients with resolved MODS on day 7 of sepsis, Ang-1 levels were increased from day 1 (4.7 ± 0.6 ng/mL vs 9.1 ± 1.4 ng/mL, n = 43, P = 0.004). Plasma Ang-1 levels were lower in nonsurvivors than in survivors on days 1 (4.0 ± 0.5 vs 7.1 ± 0.5 ng/mL, P < 0.0001), 3 (3.8 ± 0.6 vs 7.1 ± 0.5 ng/mL, P < 0.0001), and 7 (4.7 ± 0.7 vs 11.0 ± 0.8 ng/mL, P < 0.0001) of severe sepsis. In contrast, plasma Ang-2 levels were higher in nonsurvivors than in survivors only on day 1 (15.8 ± 2.0 vs 9.5 ± 1.2 ng/mL, P = 0.035). VEGF and Tie-2 levels were not associated with MODS and mortality. Ang-1 level less than the median value was the only independent predictor of mortality (hazard ratio, 2.57; 95% CI 1.12-5.90, P = 0.025).Persistently decreased Ang-1 levels are associated with MODS and subsequently, mortality in patients with sepsis.
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Lin et al. (2015) conducted a cohort in Severe sepsis (n=96). Plasma Angiopoietin-1 (Ang-1) level less than the median value vs. Plasma Ang-1 level greater than or equal to the median value was evaluated on In-hospital mortality (HR 2.57, 95% CI 1.12-5.90, p=0.025). Plasma angiopoietin-1 levels below the median value independently predicted in-hospital mortality in patients with severe sepsis (HR 2.57).
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