Serum melatonin levels during the first seven days of severe sepsis diagnosis are associated with sepsis severity and mortality |
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| Authors: | Leonardo Lorente María M. Martín Pedro Abreu-González Antonia Pérez-Cejas Raquel Ortiz López José Ferreres Jordi Solé-Violán Lorenzo Labarta César Díaz Celina Llanos Alejandro Jiménez |
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| Affiliation: | 1. Intensive Care Unit, Hospital Universitario de Canarias, Ofra, Tenerife, Spain;2. Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Santa Cruz Tenerife, Spain;3. Deparment of Physiology, Faculty of Medicine, University of the La Laguna, Santa Cruz de Tenerife, Spain;4. Laboratory Department, Hospital Universitario de Canarias, Tenerife, Spain;5. Intensive Care Unit, Hospital General de La Palma, La Palma, Spain;6. Intensive Care Unit, Hospital Clínico Universitario de Valencia, Valencia, Spain;7. Intensive Care Unit, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain;8. Intensive Care Unit, Hospital San Jorge de Huesca, Huesca, Spain;9. Intensive Care Unit, Hospital Insular, Las Palmas de Gran Canaria, Spain;10. Intensive Care Unit, Hospital Quirón Tenerife, Santa Cruz de Tenerife, Spain;11. Research Unit, Hospital Universitario de Canarias, Tenerife, Spain |
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| Abstract: | ObjectiveHigher serum melatonin levels have previously been found in patients with severe sepsis who died within 30 days of diagnosis than in survivors. The objective of our study were to determine whether serum melatonin levels during the first seven days of severe sepsis diagnosis could be associated with sepsis severity and mortality.MethodsMulticentre study in eight Spanish Intensive Care Units which enrolled 308 patients with severe sepsis. We determined serum levels of melatonin, malondialdehyde (as biomarker of lipid peroxidation) and tumor necrosis factor-alpha at days 1, 4 and 8 of severe sepsis diagnosis. The study's primary endpoint was 30-day mortality.ResultsA total of 103 patients had died and 205 survived at 30 days of severe sepsis diagnosis, with the non-survivors presenting higher serum melatonin levels at days 1 (p < 0.001), 4 (p < 0.001) and 8 (p < 0.001) of severe sepsis diagnosis than the survivor patient group. The multiple logistic regression analysis found that serum melatonin levels at days 1, 4 and 8 of severe sepsis diagnosis (p < 0.001, p = 0.01 and p = 0.001, respectively) were associated with mortality adjusted for age, serum lactic acid, SOFA score and diabetes mellitus.ConclusionsThe novel and more interesting findings of our study were that serum melatonin levels during the first seven days of severe sepsis diagnosis are associated with sepsis severity and mortality. |
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| Keywords: | Melatonin Sepsis Mortality Patients Melatonina Sepsis Mortalidad Pacientes |
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