title: Serum melatonin levels are associated with mortality in severe septic patients.
abstract: OBJECTIVE
  Melatonin in septic patients has been scarcely explored and only in studies of small sample size (maximum 20 patients). Thus, the objective of this study was to determine whether serum melatonin levels are associated with severity, oxidant and inflammatory state, and mortality in a large series of septic patients.
  
  
  METHODS
  A prospective, observational, multicenter study was performed in 6 Spanish intensive care units with 201 severe septic patients. Serum levels of melatonin were measured at moment of severe sepsis diagnosis. The end point was 30-day mortality.
  
  
  RESULTS
  Non-surviving patients (n = 71) showed higher serum melatonin levels (P < .001) than survivors (n = 130). Multiple logistic regression analysis showed that serum melatonin levels were associated with 30-day mortality (odds ratio, 1.022; 95% confidence interval, 1.001-1.043; P = .04), controlling for serum tumor necrosis factor-α levels, serum interleukin 6 levels and age. Serum melatonin levels were positively associated with serum levels of malondialdehyde as biomarker of oxidative stress, interleukin-6 and lactate, and with SOFA score.
  
  
  CONCLUSIONS
  The novel finding of our study was that serum melatonin levels are associated with mortality in septic patients.
authors: Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320, Santa Cruz de Tenerife, Spain. Electronic address: lorentemartin@msn.com.
authors: Leonardo
authors: L
authors: Lorente
authors: Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Crta Rosario s/n. Santa Cruz Tenerife, 38010, Spain. Electronic address: mar.martinvelasco@gmail.com.
authors: María M
authors: MM
authors: Martín
authors: Deparment of Phisiology, Faculty of Medicine, University of the La Laguna, Ofra, s/n. La Laguna, 38320, Santa Cruz de Tenerife, Spain. Electronic address: pabreu@ull.es.
authors: Pedro
authors: P
authors: Abreu-González
authors: Faculty of Pharmacy, University of the La Laguna, Avda. Astrofísico Francisco Sánchez s/n, La Laguna, Tenerife, 38071, Spain. Electronic address: thaisdelacruz@gmail.com.
authors: Thais
authors: T
authors: de la Cruz
authors: Intensive Care Unit, Hospital Clínico Universitario de Valencia, Avda. Blasco Ibáñez n°17-19, Valencia, 46004, Spain. Electronic address: ferreresj@gmail.com.
authors: José
authors: J
authors: Ferreres
authors: Intensive Care Unit, Hospital Universitario Dr. Negrín, Barranco de la Ballena s/n. Las Palmas de Gran Canaria, 35010, Spain. Electronic address: jsolvio@gobiernodecanarias.org.
authors: Jordi
authors: J
authors: Solé-Violán
authors: Intensive Care Unit, Hospital San Jorge de Huesca, Avenida Martínez de Velasco n°36, Huesca, 22004, Spain. Electronic address: llabarta@salud.aragon.es.
authors: Lorenzo
authors: L
authors: Labarta
authors: Intensive Care Unit, Hospital Insular, Plaza Dr. Pasteur s/n. Las Palmas de Gran Canaria, 35016, Spain. Electronic address: incaicos@yahoo.es.
authors: César
authors: C
authors: Díaz
authors: Research Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320, Santa Cruz de Tenerife, Spain. Electronic address: ajimenezsosa@gmail.com.
authors: Alejandro
authors: A
authors: Jiménez
authors: Laboratory Department, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain. Electronic address: jmborreguero@hotmail.com.
authors: Juan M
authors: JM
authors: Borreguero-León
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D015850:Interleukin-6 / Q000097:blood*; D019344:Lactic Acid / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008315:Malondialdehyde / Q000097:blood*; D008550:Melatonin / Q000097:blood*; D008875:Middle Aged; D016017:Odds Ratio; D018384:Oxidative Stress; D011379:Prognosis; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood* / Q000401:mortality; D012720:Severity of Illness Index; D017741:Survivors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; D019344:Lactic Acid; D008315:Malondialdehyde; D008550:Melatonin
keywords: Melatonin; Mortality; Outcome; Sepsis