The Lectin Complement Pathway in Patients with Necrotizing Soft Tissue Infection
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The Lectin Complement Pathway in Patients with Necrotizing Soft Tissue Infection. / Hansen, Marco Bo; Rasmussen, Lars S; Pilely, Katrine; Hellemann, Dorthe; Hein, Estrid; Madsen, Martin Bruun; Hyldegaard, Ole; Garred, Peter.
In: Journal of Innate Immunity, Vol. 8, No. 5, 2016, p. 507-16.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - The Lectin Complement Pathway in Patients with Necrotizing Soft Tissue Infection
AU - Hansen, Marco Bo
AU - Rasmussen, Lars S
AU - Pilely, Katrine
AU - Hellemann, Dorthe
AU - Hein, Estrid
AU - Madsen, Martin Bruun
AU - Hyldegaard, Ole
AU - Garred, Peter
N1 - © 2016 S. Karger AG, Basel.
PY - 2016
Y1 - 2016
N2 - BACKGROUND: Mannose-binding lectin (MBL) and ficolins are pattern recognition molecules (PRMs) that play an important role during infection through activation of the lectin complement pathway. We assessed whether plasma PRM levels were associated with mortality in patients with necrotizing soft tissue infection (NSTI).METHODS: We conducted a prospective, observational study over 25 months involving 135 NSTI patients with a maximum follow-up of 2.7 years. Blood samples were taken upon admission. Non-infected patients served as controls.RESULTS: PRM levels were significantly lower compared with controls. A baseline Ficolin-2 level below the median was associated with mortality at the end of follow-up (p = 0.007). No significant association was found for MBL, Ficolin-1 and Ficolin-3. A Ficolin-2 level below the median had a negative predictive value of 0.94 for 28-day mortality, and a level below the optimal cut-off was independently associated with 28-day mortality when adjusted for age, sex and chronicity [hazard ratio 6.27 (95% confidence interval 2.28-17.21), p < 0.0001], also when Simplified Acute Physiology Score II was included in the analysis [hazard ratio 3.16 (95% confidence interval 1.03-9.73), p = 0.045].CONCLUSIONS: All PRMs were significantly lower in patients with NSTI than in controls. Only baseline Ficolin-2 was associated with short- and long-term mortality. A high baseline Ficolin-2 level indicated a 94% chance of surviving the first 28 days after admission.
AB - BACKGROUND: Mannose-binding lectin (MBL) and ficolins are pattern recognition molecules (PRMs) that play an important role during infection through activation of the lectin complement pathway. We assessed whether plasma PRM levels were associated with mortality in patients with necrotizing soft tissue infection (NSTI).METHODS: We conducted a prospective, observational study over 25 months involving 135 NSTI patients with a maximum follow-up of 2.7 years. Blood samples were taken upon admission. Non-infected patients served as controls.RESULTS: PRM levels were significantly lower compared with controls. A baseline Ficolin-2 level below the median was associated with mortality at the end of follow-up (p = 0.007). No significant association was found for MBL, Ficolin-1 and Ficolin-3. A Ficolin-2 level below the median had a negative predictive value of 0.94 for 28-day mortality, and a level below the optimal cut-off was independently associated with 28-day mortality when adjusted for age, sex and chronicity [hazard ratio 6.27 (95% confidence interval 2.28-17.21), p < 0.0001], also when Simplified Acute Physiology Score II was included in the analysis [hazard ratio 3.16 (95% confidence interval 1.03-9.73), p = 0.045].CONCLUSIONS: All PRMs were significantly lower in patients with NSTI than in controls. Only baseline Ficolin-2 was associated with short- and long-term mortality. A high baseline Ficolin-2 level indicated a 94% chance of surviving the first 28 days after admission.
KW - Journal Article
U2 - 10.1159/000447327
DO - 10.1159/000447327
M3 - Journal article
C2 - 27355483
VL - 8
SP - 507
EP - 516
JO - Journal of Innate Immunity
JF - Journal of Innate Immunity
SN - 1662-811X
IS - 5
ER -
ID: 176966875