Serum melatonin levels during the first seven days of severe sepsis diagnosis are associated with sepsis severity and mortality

Leonardo Lorente; María M Martín; Pedro Abreu-González; Antonia Pérez-Cejas; Raquel Ortiz López; José Ferreres; Jordi Solé-Violán; Lorenzo Labarta; César Díaz; Celina Llanos; Alejandro Jiménez

doi:10.1016/j.eimc.2017.10.024

Serum melatonin levels during the first seven days of severe sepsis diagnosis are associated with sepsis severity and mortality

Enferm Infecc Microbiol Clin (Engl Ed). 2018 Nov;36(9):544-549. doi: 10.1016/j.eimc.2017.10.024. Epub 2017 Dec 1.

[Article in English, Spanish]

Authors

Affiliations

¹ Intensive Care Unit, Hospital Universitario de Canarias, Ofra, Tenerife, Spain. Electronic address: [email protected].
² Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Santa Cruz Tenerife, Spain.
³ Deparment of Physiology, Faculty of Medicine, University of the La Laguna, Santa Cruz de Tenerife, Spain.
⁴ Laboratory Department, Hospital Universitario de Canarias, Tenerife, Spain.
⁵ Intensive Care Unit, Hospital General de La Palma, La Palma, Spain.
⁶ Intensive Care Unit, Hospital Clínico Universitario de Valencia, Valencia, Spain.
⁷ Intensive Care Unit, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain.
⁸ Intensive Care Unit, Hospital San Jorge de Huesca, Huesca, Spain.
⁹ Intensive Care Unit, Hospital Insular, Las Palmas de Gran Canaria, Spain.
¹⁰ Intensive Care Unit, Hospital Quirón Tenerife, Santa Cruz de Tenerife, Spain.
¹¹ Research Unit, Hospital Universitario de Canarias, Tenerife, Spain.

PMID: 29198774
DOI: 10.1016/j.eimc.2017.10.024

Abstract

Objective: Higher serum melatonin levels have previously been found in patients with severe sepsis who died within 30 days of diagnosis than in survivors. The objective of our study were to determine whether serum melatonin levels during the first seven days of severe sepsis diagnosis could be associated with sepsis severity and mortality.

Methods: Multicentre study in eight Spanish Intensive Care Units which enrolled 308 patients with severe sepsis. We determined serum levels of melatonin, malondialdehyde (as biomarker of lipid peroxidation) and tumor necrosis factor-alpha at days 1, 4 and 8 of severe sepsis diagnosis. The study's primary endpoint was 30-day mortality.

Results: A total of 103 patients had died and 205 survived at 30 days of severe sepsis diagnosis, with the non-survivors presenting higher serum melatonin levels at days 1 (p<0.001), 4 (p<0.001) and 8 (p<0.001) of severe sepsis diagnosis than the survivor patient group. The multiple logistic regression analysis found that serum melatonin levels at days 1, 4 and 8 of severe sepsis diagnosis (p<0.001, p=0.01 and p=0.001, respectively) were associated with mortality adjusted for age, serum lactic acid, SOFA score and diabetes mellitus.

Conclusions: The novel and more interesting findings of our study were that serum melatonin levels during the first seven days of severe sepsis diagnosis are associated with sepsis severity and mortality.

Keywords: Melatonin; Melatonina; Mortalidad; Mortality; Pacientes; Patients; Sepsis.

Publication types

Multicenter Study
Observational Study

MeSH terms

Aged
Comorbidity
Female
Follow-Up Studies
Hospital Mortality
Humans
Intensive Care Units
Kaplan-Meier Estimate
Male
Malondialdehyde / blood
Melatonin / blood*
Middle Aged
Prospective Studies
Sepsis / blood*
Sepsis / mortality
Severity of Illness Index
Spain / epidemiology
Tumor Necrosis Factor-alpha / blood

Substances

Tumor Necrosis Factor-alpha
Malondialdehyde
Melatonin