Plasma protein C levels in immunocompromised septic patients are significantly lower than immunocompetent septic patients: a prospective cohort study

Panwar, Rakshit, Venkatesh, Bala, Kruger, Peter, Bird, Robert, Gill, Devinder, Nunnink, Leo and Dimeski, Goce (2009) Plasma protein C levels in immunocompromised septic patients are significantly lower than immunocompetent septic patients: a prospective cohort study. Journal of Hematology and Oncology, 2 43: xx-xx. doi:10.1186/1756-8722-2-43


Author Panwar, Rakshit
Venkatesh, Bala
Kruger, Peter
Bird, Robert
Gill, Devinder
Nunnink, Leo
Dimeski, Goce
Title Plasma protein C levels in immunocompromised septic patients are significantly lower than immunocompetent septic patients: a prospective cohort study
Journal name Journal of Hematology and Oncology   Check publisher's open access policy
ISSN 1756-8722
Publication date 2009-10-01
Year available 2009
Sub-type Article (original research)
DOI 10.1186/1756-8722-2-43
Open Access Status DOI
Volume 2
Issue 43
Start page xx
End page xx
Total pages 8
Editor Delong Liu
Place of publication United Kingdom
Publisher BioMed Central
Language eng
Subject 1102 Cardiovascular Medicine and Haematology
1112 Oncology and Carcinogenesis
C1
Abstract Introduction: Activated Protein C [APC] improves outcome in immunocompetent patients with severe sepsis particularly in those who are perceived to have high mortality risk. Before embarking on a trial of APC administration in immunocompromised septic patients, a preliminary study on plasma levels of protein C in this cohort is essential.
Formatted abstract
Introduction

Activated Protein C [APC] improves outcome in immunocompetent patients with severe sepsis particularly in those who are perceived to have high mortality risk. Before embarking on a trial of APC administration in immunocompromised septic patients, a preliminary study on plasma levels of protein C in this cohort is essential.

Objective


To assess serum Protein C concentrations in immunocompromised patients as compared to immunocompetent patients during sepsis, severe sepsis, septic shock and recovery.

Methods


Prospective cohort study in a tertiary hospital. Patients satisfying inclusion criteria were enrolled after informed consent. Clinical variables were noted with sample collection when patients met criteria for sepsis, severe sepsis, septic shock and recovery. Protein C levels were measured using monoclonal antibody based fluorescence immunoassay.

Results


Thirty one patients participated in this study (22 immunocompromised, 9 immunocompetent). Protein C levels were found to be significantly lower in the immunocompromised group compared to the immunocompetent group, particularly observed in severe sepsis [2.27 (95% CI: 1.63-2.9) vs 4.19 (95% CI: 2.87-5.52) mcg/ml] (p = 0.01) and sepsis [2.59 (95% CI: 1.98-3.21) vs 3.64 (95% CI: 2.83-4.45) mcg/ml] (p = 0.03). SOFA scores were similar in both the groups across sepsis, severe sepsis and septic shock categories. Protein C levels improved significantly in recovery (p = 0.001) irrespective of immune status.

Conclusion

Protein C levels were significantly lower in immunocompromised patients when compared to immunocompetent patients in severe sepsis and sepsis categories. Our study suggests a plausible role for APC in severely septic immunocompromised patients which need further elucidation.
Keyword Oncology
Hematology
Oncology
Hematology
HEMATOLOGY
ONCOLOGY
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Sun, 13 Dec 2009, 10:04:50 EST