title: Elevated serum vascular cell adhesion molecule-1 is associated with septic encephalopathy in adult community-onset severe sepsis patients.
abstract: OBJECTIVE
  Septic encephalopathy (SE) is a common complication of severe sepsis. Increased concentrations of circulating soluble adhesion molecules are reported in septic patients. This study aimed to determine whether serum adhesion molecules are associated with SE.
  
  
  METHODS
  Seventy nontraumatic, nonsurgical adult patients with severe sepsis admitted through ER were evaluated. Serum adhesion molecules were assessed for their relationship with SE, and compared with other clinical predictors and biomarkers.
  
  
  RESULTS
  Twenty-three (32.8%) patients had SE. SE group had higher in-hospital mortality (40% versus 11%, P = 0.009) and their sVCAM-1, sICAM-1, and lactate levels on admission were also higher than non-SE group. By stepwise logistic regression model, sVCAM-1, age, and maximum 24-hours SOFA score were independently associated with septic encephalopathy. The AUC analysis of ROC curve of different biomarkers showed that sVCAM-1 is better to predict SE. The sVCAM-1 levels in the SE group were significantly higher than those of the non-SE group at three time periods (Days 1, 4, and 7).
  
  
  CONCLUSIONS
  Septic encephalopathy implies higher mortality in nontraumatic, nonsurgical patients with severe sepsis. VCAM-1 level on presentation is a more powerful predictor of SE in these patients than lactate concentration and other adhesion molecules on admission.
authors.affiliation: Department of Biological Science, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan ; Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung 833, Taiwan.
authors.forename: Chih-Min
authors.initials: CM
authors.lastname: Su
authors.affiliation: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung 833, Taiwan.
authors.forename: Hsien-Hung
authors.initials: HH
authors.lastname: Cheng
authors.affiliation: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung 833, Taiwan.
authors.forename: Tsung-Cheng
authors.initials: TC
authors.lastname: Tsai
authors.affiliation: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung 833, Taiwan.
authors.forename: Sheng-Yuan
authors.initials: SY
authors.lastname: Hsiao
authors.affiliation: Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung 833, Taiwan.
authors.forename: Nai-Wen
authors.initials: NW
authors.lastname: Tsai
authors.affiliation: Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung 833, Taiwan.
authors.forename: Wen-Neng
authors.initials: WN
authors.lastname: Chang
authors.affiliation: Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung 833, Taiwan.
authors.forename: Wei-Che
authors.initials: WC
authors.lastname: Lin
authors.affiliation: Department of Biological Science, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan ; Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung 833, Taiwan.
authors.forename: Ben-Chung
authors.initials: BC
authors.lastname: Cheng
authors.affiliation: Department of Biological Science, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan ; Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung 833, Taiwan.
authors.forename: Yu-Jih
authors.identifier: 0000-0002-7274-3458
authors.initials: YJ
authors.lastname: Su
authors.affiliation: Department of Biological Science, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan ; Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung 833, Taiwan.
authors.forename: Ya-Ting
authors.initials: YT
authors.lastname: Chang
authors.affiliation: Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung 833, Taiwan.
authors.forename: Yi-Fang
authors.initials: YF
authors.lastname: Chiang
authors.affiliation: Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung 833, Taiwan.
authors.forename: Chia-Te
authors.initials: CT
authors.lastname: Kung
authors.affiliation: Department of Biological Science, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan ; Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung 833, Taiwan.
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Lu
mesh_terms: D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000097:blood* / Q000150:complications / Q000401:mortality; D065166:Sepsis-Associated Encephalopathy / Q000097:blood* / Q000150:complications; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*
chemical_list: D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D019344:Lactic Acid