title: Altered balance of the aminogram in patients with sepsis - the relation to mortality.
abstract: OBJECTIVE
  Protein metabolism is important in healing wounds, supporting immune function, and maintaining lean body mass. Determination of adequate requirements of amino acids has not been thoroughly clarified in critically ill patients. The purpose of this study was to evaluate 23 plasma amino acids in patients with sepsis and determine prognostic factors.
  
  
  METHODS
  This study was a retrospective study. Plasma aminograms were measured in patients with sepsis. We evaluated minimum and maximum values of each amino acid and evaluated prognostic factors by multivariate logistic regression analysis and classification and regression tree (CART) analysis.
  
  
  RESULTS
  The study comprised 77 patients. The median intensive care unit (ICU) stay was 30 days (interquartile range 19.5-55.5 days). Whole mortality rate was 39.0%. Maximum values of glutamine, glutamate, glycine, alanine, methionine, phenylalanine, and histidine and minimum values of glutamate, taurine, serine, isoleucine, leucine, tyrosine, ornithine, tryptophan, and arginine were significantly different between survivors and non-survivors (P < 0.05). Statistical analysis using CART analysis revealed the minimum value of glutamate and maximum value of methionine to be significant prognostic factors for mortality (P < 0.05).
  
  
  CONCLUSIONS
  Plasma aminograms were significantly altered in patients with sepsis. Altered balance of aminograms was significantly associated with mortality in patients with sepsis requiring a long ICU stay.
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan. Electronic address: htomoya1979@hp-emerg.med.osaka-u.ac.jp.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Hirose
authors.affiliation: Department of Clinical Quality Management, Osaka University Hospital, Osaka, Japan. Electronic address: shimiken@hp-emerg.med.osaka-u.ac.jp.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan. Electronic address: ogura@hp-emerg.med.osaka-u.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogura
authors.affiliation: Emergency Medical Center, Nagasaki University Hospital, Nagasaki, Japan. Electronic address: tasaki-o@nagasaki-u.ac.jp.
authors.forename: Osamu
authors.initials: O
authors.lastname: Tasaki
authors.affiliation: Department of Biomedical Statistics, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: hamasakt@medstat.med.osaka-u.ac.jp.
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Hamasaki
authors.affiliation: Emergency Medical Center, Nagasaki University Hospital, Nagasaki, Japan. Electronic address: snipeshu@gmail.com.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Yamano
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan. Electronic address: mohnishi@hp-emerg.med.osaka-u.ac.jp.
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Ohnishi
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan. Electronic address: kuwagata@hp-emerg.med.osaka-u.ac.jp.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kuwagata
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan. Electronic address: shimazu@hp-emerg.med.osaka-u.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimazu
mesh_terms: D000368:Aged; D000596:Amino Acids / Q000008:administration & dosage / Q000097:blood*; D016638:Critical Illness / Q000401:mortality* / Q000628:therapy*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009751:Nutritional Requirements; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood* / Q000401:mortality*
chemical_list: D000596:Amino Acids
keywords: APACHE; Amino acids; CART; Glutamate; ICU; IQR; Methionine; Prognosis; S-adenosylmethionine; SAM; SOFA; Sepsis; acute physiological and chronic health evaluation; classification and regression tree; intensive care unit; interquartile range; sequential organ failure assessment