title: Baseline thrombospondin-1 concentrations are not associated with mortality in septic patients: a single-center cohort study on the intensive care unit.
abstract: BACKGROUND
  The initial phase of sepsis is characterized by hyperinflammation. Levels of thrombospondin-1 (TSP-1) rise rapidly during acute inflammation. The purpose of this clinical study was to study the association between plasma TSP-1 levels and mortality in patients with sepsis on the intensive care unit.
  
  
  METHODS
  Critically ill adult patients with sepsis, severe sepsis, or septic shock were included. They were further divided into tertiles based on their baseline plasma TSP-1 concentrations. Primary outcome measure was 28-day mortality. Furthermore, associations with severity of sepsis and platelet counts were studied.
  
  
  RESULTS
  Two hundred thirty-five patients were included. Median plasma TSP-1 concentrations of the tertiles were 194, 463 and 874 ng/mL, respectively. There were no baseline differences. Mortality rates (26.6, 16.7, and 16.7%, p = 0.20) and cumulative survival curves (p = 0.22) were not statistically different between the tertiles. There was no association of baseline TSP-1 with severity of sepsis (p = 0.08). TSP-1 and platelet counts were positively correlated (159, 198, and 295 × 109/L, p = 0.04).
  
  
  CONCLUSIONS
  Baseline plasma levels of TSP-1 were not associated with mortality and severity of sepsis in mixed population of septic ICU patients. Further research is needed to clarify the expression of TSP-1 and to unravel the potential prognostic value of this biomarker in human sepsis.
authors.affiliation: Intensive Care Department, University Medical Center Utrecht, Room F06.149, 3508 GA, Utrecht, the Netherlands. R.J.vanderWekken-3@umcutrecht.nl.
authors.forename: Ruben J
authors.initials: RJ
authors.lastname: van der Wekken
authors.affiliation: Department of Clinical Chemistry and Haematology, University Medical Center, University Utrecht, Utrecht, the Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Kemperman
authors.affiliation: Synapse B.V., Maastricht, the Netherlands.
authors.forename: Mark
authors.initials: M
authors.lastname: Roest
authors.affiliation: Intensive Care Department, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands.
authors.forename: Dylan W
authors.initials: DW
authors.lastname: de Lange
keywords: Biomarker; Intensive care unit; Mortality; Outcome; Sepsis; Thrombospondin-1