Increased serum thrombomodulin level is associated with disease severity and mortality in pediatric sepsis.
<h4>Background</h4>Endothelial dysfunction plays an important role in the pathophysiology of sepsis. As previously reported, the serum thrombomodulin is elevated in diseases associated with endothelial injury.<h4>Objective</h4>The aim of this study was to investigate the asso...
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2017-01-01
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| author | Jainn-Jim Lin Hsiang-Ju Hsiao Oi-Wa Chan Yu Wang Shao-Hsuan Hsia Cheng-Hsun Chiu |
| author_facet | Jainn-Jim Lin Hsiang-Ju Hsiao Oi-Wa Chan Yu Wang Shao-Hsuan Hsia Cheng-Hsun Chiu |
| author_sort | Jainn-Jim Lin |
| collection | DOAJ |
| description | <h4>Background</h4>Endothelial dysfunction plays an important role in the pathophysiology of sepsis. As previously reported, the serum thrombomodulin is elevated in diseases associated with endothelial injury.<h4>Objective</h4>The aim of this study was to investigate the association of serum thrombomodulin level in different pediatric sepsis syndromes and evaluate the relationship with disease severity and mortality.<h4>Methods</h4>We prospectively collected cases of sepsis treated in a pediatric intensive care unit from June 2012 to July 2015 at Chang Gung Children's Hospital in Taoyuan, Taiwan. Clinical characteristics and serum thrombomodulin levels were analyzed.<h4>Results</h4>Increased serum thrombomodulin levels on days 1 and 3 of the diagnosis of sepsis were found in different pediatric sepsis syndromes. Patients with septic shock had significantly increased serum thrombomodulin levels on days 1 and 3 [day 1: median, 6.9 mU/ml (interquartile range (IQR): 5.8-12.8) and day 3: median, 5.8 mU/ml (IQR: 4.6-10.8)] compared to healthy controls [median, 3.4 mU/ml (IQR: 2.3-4.2)] (p = <0.001 and 0.001, respectively) and those with sepsis [day 1: median, 2.9 mU/ml (IQR: 1.8-4.7) and day 3: median, 3 mU/ml (IQR: 1.5-3.5)] and severe sepsis [day 1: median, 3.3 mU/ml (IQR: 1.3-8.6) and day 3: median, 4.4 mU/ml (IQR: 0.5-6)] (p = <0.001 and 0.001, respectively). There was also a significant positive correlation between serum thrombomodulin level on day 1 and day 1 PRISM-II, PELOD, P-MOD and DIC scores. The patients who died had significantly higher serum thrombomodulin levels on days 1 and 3 [day 1: median, 9.9 mU/ml (IQR: 6.2-15.6) and day 3: median, 10.4 mU/ml (IQR: 9.2-11.7)] than the survivors [day 1; median, 4.4 mU/ml (IQR: 2.2-7.5) and day 3: [median, 3.5 mU/ml (IQR: 1.6-5.7)] (p = 0.046 and 0.012, respectively).<h4>Conclusion</h4>Increased serum thrombomodulin levels were found in different pediatric sepsis syndromes and correlated with disease severity and mortality. |
| format | Article |
| id | doaj-art-7f2cde84b3d649788203e38a9055d3be |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2017-01-01 |
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| spelling | doaj-art-7f2cde84b3d649788203e38a9055d3be2025-08-20T02:03:59ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01128e018232410.1371/journal.pone.0182324Increased serum thrombomodulin level is associated with disease severity and mortality in pediatric sepsis.Jainn-Jim LinHsiang-Ju HsiaoOi-Wa ChanYu WangShao-Hsuan HsiaCheng-Hsun Chiu<h4>Background</h4>Endothelial dysfunction plays an important role in the pathophysiology of sepsis. As previously reported, the serum thrombomodulin is elevated in diseases associated with endothelial injury.<h4>Objective</h4>The aim of this study was to investigate the association of serum thrombomodulin level in different pediatric sepsis syndromes and evaluate the relationship with disease severity and mortality.<h4>Methods</h4>We prospectively collected cases of sepsis treated in a pediatric intensive care unit from June 2012 to July 2015 at Chang Gung Children's Hospital in Taoyuan, Taiwan. Clinical characteristics and serum thrombomodulin levels were analyzed.<h4>Results</h4>Increased serum thrombomodulin levels on days 1 and 3 of the diagnosis of sepsis were found in different pediatric sepsis syndromes. Patients with septic shock had significantly increased serum thrombomodulin levels on days 1 and 3 [day 1: median, 6.9 mU/ml (interquartile range (IQR): 5.8-12.8) and day 3: median, 5.8 mU/ml (IQR: 4.6-10.8)] compared to healthy controls [median, 3.4 mU/ml (IQR: 2.3-4.2)] (p = <0.001 and 0.001, respectively) and those with sepsis [day 1: median, 2.9 mU/ml (IQR: 1.8-4.7) and day 3: median, 3 mU/ml (IQR: 1.5-3.5)] and severe sepsis [day 1: median, 3.3 mU/ml (IQR: 1.3-8.6) and day 3: median, 4.4 mU/ml (IQR: 0.5-6)] (p = <0.001 and 0.001, respectively). There was also a significant positive correlation between serum thrombomodulin level on day 1 and day 1 PRISM-II, PELOD, P-MOD and DIC scores. The patients who died had significantly higher serum thrombomodulin levels on days 1 and 3 [day 1: median, 9.9 mU/ml (IQR: 6.2-15.6) and day 3: median, 10.4 mU/ml (IQR: 9.2-11.7)] than the survivors [day 1; median, 4.4 mU/ml (IQR: 2.2-7.5) and day 3: [median, 3.5 mU/ml (IQR: 1.6-5.7)] (p = 0.046 and 0.012, respectively).<h4>Conclusion</h4>Increased serum thrombomodulin levels were found in different pediatric sepsis syndromes and correlated with disease severity and mortality.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0182324&type=printable |
| spellingShingle | Jainn-Jim Lin Hsiang-Ju Hsiao Oi-Wa Chan Yu Wang Shao-Hsuan Hsia Cheng-Hsun Chiu Increased serum thrombomodulin level is associated with disease severity and mortality in pediatric sepsis. PLoS ONE |
| title | Increased serum thrombomodulin level is associated with disease severity and mortality in pediatric sepsis. |
| title_full | Increased serum thrombomodulin level is associated with disease severity and mortality in pediatric sepsis. |
| title_fullStr | Increased serum thrombomodulin level is associated with disease severity and mortality in pediatric sepsis. |
| title_full_unstemmed | Increased serum thrombomodulin level is associated with disease severity and mortality in pediatric sepsis. |
| title_short | Increased serum thrombomodulin level is associated with disease severity and mortality in pediatric sepsis. |
| title_sort | increased serum thrombomodulin level is associated with disease severity and mortality in pediatric sepsis |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0182324&type=printable |
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