title: Serum surfactant protein D (SP-D) is a prognostic marker of poor outcome in patients with A/H1N1 virus infection.
abstract: BACKGROUND
  Surfactant protein D (SP-D) plays an important role in the innate responses against pathogens and its production is altered in lung disorders.
  
  
  METHODS
  We studied the circulating levels of SP-D in 37 patients with acute respiratory distress syndrome due to the A/H1N1 virus infection and in 40 healthy controls. Cox logistic regression models were constructed to explore the association of SP-D levels and risk of death.
  
  
  RESULTS
  Mortality rate after a 28-day was 32.42 %. Significant higher levels of SP-D were detected in A/H1N1 patients with fatal outcome (p < 0.05). After adjusting for confounding variables, levels of SP-D ≥250 ng/mL were associated with increased the risk of death (HR = 8.27, 95 % CI 1.1-64.1, p = 0.043).
  
  
  CONCLUSIONS
  Our results revealed that higher circulating levels of SP-D are associated with higher mortality risk in critically ill A/H1N1 patients. SP-D might be a predictive factor of poor outcomes in viral pneumonia.
authors.affiliation: Surgical Intensive Care Unit, Centro Médico Nacional "20 de Noviembre", ISSSTE, Mexico City, Mexico.
authors.forename: Carlos
authors.initials: C
authors.lastname: Delgado
authors.forename: Edgar
authors.initials: E
authors.lastname: Krötzsch
authors.forename: Luis A
authors.initials: LA
authors.lastname: Jiménez-Alvarez
authors.forename: Gustavo
authors.initials: G
authors.lastname: Ramírez-Martínez
authors.forename: Jose E
authors.initials: JE
authors.lastname: Márquez-García
authors.forename: Alfredo
authors.initials: A
authors.lastname: Cruz-Lagunas
authors.forename: Juan
authors.initials: J
authors.lastname: Morán
authors.forename: Cármen
authors.initials: C
authors.lastname: Hernández
authors.forename: Patricia
authors.initials: P
authors.lastname: Sierra-Vargas
authors.forename: Federico
authors.initials: F
authors.lastname: Avila-Moreno
authors.forename: Carina
authors.initials: C
authors.lastname: Becerril
authors.forename: Martha
authors.initials: M
authors.lastname: Montaño
authors.forename: José L
authors.initials: JL
authors.lastname: Bañales-Méndez
authors.forename: Joaquín
authors.initials: J
authors.lastname: Zúñiga
authors.forename: Ivette
authors.initials: I
authors.lastname: Buendía-Roldán
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D016638:Critical Illness; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000472:pathogenicity*; D007251:Influenza, Human / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy / Q000821:virology; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011024:Pneumonia, Viral / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy / Q000821:virology; D011379:Prognosis; D016016:Proportional Hazards Models; D037663:Pulmonary Surfactant-Associated Protein D / Q000097:blood*; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy / Q000821:virology; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D037663:Pulmonary Surfactant-Associated Protein D