Relationship of plasma gelsolin levels to outcomes in critically ill surgical patients.
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.


CONCLUSIONS
Plasma gelsolin is a potential prognostic biomarker for critically ill surgical patients. Plasma gelsolin replacement may have therapeutic application.
Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, MA, USA.
Po-Shun
PS
Lee
Leslie R
LR
Drager
Thomas P
TP
Stossel
Francis D
FD
Moore
Selwyn O
SO
Rogers
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D018260:Gelsolin / Q000097:blood*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013050:Spectrometry, Fluorescence; D013514:Surgical Procedures, Operative / Q000401:mortality*; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology
D015415:Biomarkers; D018260:Gelsolin