Intercellular adhesion molecules and mortality for sepsis in infants younger than 1 year of life.

BACKGROUND

Adhesion molecules in sepsis syndrome are correlated with the severity of illness and may be considered as predictors of survival outcome in adults. However, only few studies have been performed in infants and none using international criteria for sepsis.

OBJECTIVE

To determine whether adhesion molecules during the first 7 days of the disease could predict sepsis outcome and its severity.

MATERIAL AND METHODS

We performed a prospective study in 88 infants with sepsis and 30 controls. Soluble intercellular adhesion molecule (ICAM)-1, vascular cell adhesion molecule (VCAM)-1, and E-selectin levels were determined at days 1, 3 and 7 of follow-up in those patients with sepsis and only one determination in the control group. The main outcome measure was mortality during 10 days of monitoring.

RESULTS

Positive hemoculture was reported in 64(72.7%). ICAM-1, VCAM-1, and E-selectin levels were higher in the group of sepsis than in the control group. However, no association was found between ICAM-1, VCAM-1 or E-selectin levels with sepsis severity. Mortality linked to sepsis was observed in 9 patients (10.2%). In the logistic regression analysis, those variables positively associated with mortality were the increase in ICAM-1 levels > 250 ng/mL between day 1 to 3, number of amines and the baseline severity of sepsis. However, we did not identify in those patients who died a specific pattern in adhesion molecules levels during follow up.

CONCLUSIONS

ICAM-1 levels, number of amines and severity of sepsis levels predict mortality during 10 days of monitoring in infants younger than 1 year of age with sepsis.