title: Association between serum substance P levels and mortality in patients with severe sepsis.
abstract: BACKGROUND
  Substance P (SP) is a peptide of the tachykinins family involved in the inflammatory response. Circulating SP levels have been assessed in septic patients in 2 previous studies with a small number of subjects (61 and 42 patients, respectively), and there were no significant differences in SP levels at the moment of sepsis diagnosis between surviving and nonsurviving patients. The main goal of this study was to determine a possible relationship between serum SP levels and patient outcome in the largest cohort of severe septic patients analyzed so far.
  
  
  METHODS
  We performed an observational, prospective, multicenter study in 6 Spanish intensive care units. Serum SP levels were measured at the moment of severe sepsis diagnosis in 238 patients. The end point of the study was 30-day mortality.
  
  
  RESULTS
  We found that surviving septic patients (n = 153) showed higher serum SP levels than did nonsurvivors (n = 85). Multiple logistic regression analysis showed that serum SP levels higher than 350 pg/mL were associated with survival at 30 days (odds ratio, 0.43; 95% confidence interval, 0.24-0.77; P = .005) after controlling for serum lactic acid levels and Sepsis-related Organ Failure Assessment score.
  
  
  CONCLUSIONS
  The major new finding of our study was that serum SP levels were associated with mortality in severe septic patients.
authors.affiliation: Intensive Care Unit, Hospital Universitario de Canarias, Ofra, La Laguna, Tenerife, Spain. Electronic address: lorentemartin@msn.com.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Lorente
authors.affiliation: Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Santa Cruz, Tenerife, Spain. Electronic address: mar.martinvelasco@gmail.com.
authors.forename: María M
authors.initials: MM
authors.lastname: Martín
authors.affiliation: Unidad de Genética, Instituto de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, La Laguna, Tenerife, Spain. Electronic address: tacosalm@ull.edu.es.
authors.forename: Teresa
authors.initials: T
authors.lastname: Almeida
authors.affiliation: Unidad de Genética, Instituto de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, La Laguna, Tenerife, Spain. Electronic address: mnhdez@ull.edu.es.
authors.forename: Mariano
authors.initials: M
authors.lastname: Hernández
authors.affiliation: Intensive Care Unit, Hospital Clínico Universitario de Valencia, Valencia, Spain. Electronic address: ferreresj@gmail.com.
authors.forename: José
authors.initials: J
authors.lastname: Ferreres
authors.affiliation: Intensive Care Unit, Hospital Universitario Dr. Negrín, Barranco de la Ballena, Las Palmas de Gran Canaria, Spain. Electronic address: jsolvio@gobiernodecanarias.org.
authors.forename: Jordi
authors.initials: J
authors.lastname: Solé-Violán
authors.affiliation: Intensive Care Unit, Hospital San Jorge de Huesca, Huesca, Spain. Electronic address: llabarta@salud.aragon.es.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Labarta
authors.affiliation: Intensive Care Unit, Hospital Insular, Las Palmas de Gran Canaria, Spain. Electronic address: incaicos@yahoo.es.
authors.forename: César
authors.initials: C
authors.lastname: Díaz
authors.affiliation: Research Unit, Hospital Universitario de Canarias, Ofra, La Laguna, Tenerife, Spain. Electronic address: ajimenezsosa@gmail.com.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Jiménez
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D019344:Lactic Acid / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D063305:Organ Dysfunction Scores; D011379:Prognosis; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood / Q000401:mortality*; D013373:Substance P / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D013373:Substance P; D019344:Lactic Acid
keywords: Mortality; Outcome; Sepsis; Substance P