title: Evolution of neutrophil apoptosis in septic shock survivors and nonsurvivors.
abstract: OBJECTIVE
  The aims were to analyze the temporal evolution of neutrophil apoptosis, to determine the differences in neutrophil apoptosis among 28-day survivors and nonsurvivors, and to evaluate the use of neutrophil apoptosis as a predictor of mortality in patients with septic shock.
  
  
  METHODS
  Prospective multicenter observational study carried out between July 2006 and June 2009. The staining solution study included 80 patients with septic shock and 25 healthy volunteers. Neutrophil apoptosis was assessed by fluorescein isothiocyanate (FITC)-conjugated annexin V and aminoactinomycin D staining.
  
  
  RESULTS
  The percentage of neutrophil apoptosis was significantly decreased at 24 hours, 5 days, and 12 days after the diagnosis of septic shock (14.8% ± 13.4%, 13.4% ± 8.4%, and 15.4% ± 12.8%, respectively; P < .0001) compared with the control group (37.6% ± 12.8%). The difference in apoptosis between 28-day surviving and nonsurviving patients was nonsignificant (P > .05). The mortality rate at 28 days was 53.7%. The crude hazard ratio for mortality in patients with septic shock did not differ according to the percentage of apoptosis (hazard ratio, 1.006; 95% confidence interval, 0.98-1.03; P = .60).
  
  
  CONCLUSIONS
  During the first 12 days of septic shock development, the level of neutrophil apoptosis decreases and does not recover normal values. No differences were observed between surviving and nonsurviving patients.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Hospital Clínico Universitario de Valladolid, 47005 Valladolid, Spain. tamayo@med.uva.es
authors.forename: Eduardo
authors.initials: E
authors.lastname: Tamayo
authors.forename: Esther
authors.initials: E
authors.lastname: Gómez
authors.forename: Juan
authors.initials: J
authors.lastname: Bustamante
authors.forename: José I
authors.initials: JI
authors.lastname: Gómez-Herreras
authors.forename: Rosalba
authors.initials: R
authors.lastname: Fonteriz
authors.forename: Felipe
authors.initials: F
authors.lastname: Bobillo
authors.forename: Jesús F
authors.initials: JF
authors.lastname: Bermejo-Martín
authors.forename: Javier
authors.initials: J
authors.lastname: Castrodeza
authors.forename: Maria
authors.initials: M
authors.lastname: Heredia
authors.forename: Inma
authors.initials: I
authors.lastname: Fierro
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Álvarez
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis / Q000502:physiology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism*; D011446:Prospective Studies; D012737:Sex Factors; D012772:Shock, Septic / Q000097:blood* / Q000401:mortality*; D013997:Time Factors