지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2017.1
- 수록면
- 142 - 153 (12page)
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초록· 키워드
오류제보하기
Background: The renin-angiotensin-aldosterone system is closely associated with volume status and vascular tone in septic shock.
The present study aimed to assess whether plasma renin activity (PRA) and plasma aldosterone concentration (PAC) measurements compared with conventional severity indicators are associated with mortality in patients with septic shock.
Methods: We evaluated 105 patients who were admitted for septic shock. Plasma levels of the biomarkers PRA and PAC, the PAC/PRA ratio, C-reactive protein (CRP) level, and cortisol level on days 1, 3, and 7 were serially measured. During the intensive care unit stay, relevant clinical information and laboratory results were recorded.
Results: Patients were divided into two groups according to 28-day mortality: survivors (n = 59) and non-survivors (n = 46). The survivor group showed lower PRA, PAC, Acute Physiologic and Chronic Health Evaluation (APACHE) II score, and Sequential Organ Failure Assessment (SOFA) score than did the non-survivor group (all P < 0.05). The SOFA score was positively correlated with PRA (r = 0.373, P < 0.001) and PAC (r = 0.316, P = 0.001). According to receiver operating characteristic analysis, the areas under the curve of PRA and PAC to predict 28-day mortality were 0.69 (95% confidence interval [CI], 0.58 to 0.79; P = 0.001) and 0.67 (95% CI, 0.56 to 0.77; P = 0.003), respectively, similar to the APACHE II scores and SOFA scores. In particular, the group with PRA value ≥3.5 ng ml-1 h-1 on day 1 showed significantly greater mortality than did the group with PRA value <3.5 ng ml-1 h-1 (log-rank test, P < 0.001). According to multivariate analysis, SOFA score (hazard ratio, 1.11; 95% CI, 1.01 to 1.22), PRA value ≥3.5 ng ml-1 h-1 (hazard ratio, 3.25; 95% CI, 1.60 to 6.60), previous history of cancer (hazard ratio, 3.44; 95% CI, 1.72 to 6.90), and coronary arterial occlusive disease (hazard ratio, 2.99; 95% CI, 1.26 to 7.08) were predictors of 28-day mortality.
Conclusions: Elevated PRA is a useful biomarker to stratify the risk of critically ill patients with septic shock and is a prognostic predictor of 28-day mortality.
목차
등록된 정보가 없습니다.
참고문헌 (24)
참고문헌 신청
Angus DC / 2001 / Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care / Crit Care Med 29 : 1303 ~ 1310
Annane D / 2000 / A 3-level prognostic classification in septic shock based on cortisol levels and cortisol response to corticotropin / JAMA 283 : 1038 ~ 1045
Bone RC / 1997 / Sepsis: a new hypothesis for pathogenesis of the disease process / Chest 112 : 235 ~ 243
Cousin C / 2010 / Potential role of the (pro)renin receptor in cardiovascular and kidney diseases / J Nephrol 23 : 508 ~ 513
Doerschug KC / 2010 / Renin-angiotensin system activation correlates with microvascular dysfunction in a prospective cohort study of clinical sepsis / Crit Care 14 : R24 ~
Annane D / 2000 / A 3-level prognostic classification in septic shock based on cortisol levels and cortisol response to corticotropin / JAMA 283 : 1038 ~ 1045
Bone RC / 1997 / Sepsis: a new hypothesis for pathogenesis of the disease process / Chest 112 : 235 ~ 243
Cousin C / 2010 / Potential role of the (pro)renin receptor in cardiovascular and kidney diseases / J Nephrol 23 : 508 ~ 513
Doerschug KC / 2010 / Renin-angiotensin system activation correlates with microvascular dysfunction in a prospective cohort study of clinical sepsis / Crit Care 14 : R24 ~
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