Lower serum kallistatin level is associated with 28-day mortality in patients with septic shock

Purpose: Investigation for whether serum levels of kallistatin, vascular cell adhesion molecule-1 (VCAM-1), and E-selectin are associated with outcomes in patients with septic shock Material and methods: Biomarker levels were measured using blood samples from patients with septic shock at admission, 24 h, and 72 h and from healthy volunteers. The primary outcome was 28-day mortality. Results: Fifty-eight survivors, fourteen non-survivors, and six healthy volunteers were enrolled. Serum kallistatin level was lower and serum VCAM-1 and E-selectin levels were higher in patients at admission compared with healthy volunteers. Serum kallistatin levels were higher in survivors compared with non-survivors at all time points (4.4 mu g/mL [2.9-6.1] vs. 2.5 mu g/mL [2.1-5.0]. P = 0.019 at admission; 4.3 mu g/mL [3.3-5.2] vs. 3.2 mu g/mL [2.2-3.8], P = 0.004 at 24 h; 3.1 mu g/mL [2.5-42] vs. 2.3 mu g/m1 [1.7-3.1], P = 0.012 at 72 h), while VCAM-1 and E-selectin levels showed no difference. In the multivariable analysis, serum kallistatin level at 24 h was independently associated with 28-day mortality (OR, 029: 95% CI, 0.08-0.69, P = 0.024). Conclusions: Lower serum kallistatin level at 24 h was independently associated with 28-day mortality in patients with septic shock (C) 2018 Elsevier Inc. All rights reserved.