Rodríguez RJ, Montes OSMA, Aguirre SJ, Poblano MM, Franco GJ, Olvera GCI

Language: Spanish
References: 13
Page: 79-83
PDF size: 49.59 Kb.

ABSTRACT

Introduction: Since 1935, there is controversy whether the gender is a mortality factor in critically ill patients. Recently, it has been described that hormones play a major role in than gender. Estradiol levels › 45 pg/mL are associated with mortality in the critical patients.
Methods: Prospective study of patients admitted to the ICU in whom estradiol, erythrocyte sedimentation rate, C reactive protein and procalcitonin, as well as SOFA and APACHE II score were obtained at admittance, on day 3 and 7; mortality was evaluated 28 days later.
Results: 20 patients were included, 9 male, 11 female; 9 (45%) died and 11 survived (55%). Estradiol on days 0, 3 and 7 of patients that survived was lower tan the ones that died (41.3 ± 61.5 vs 130 ± 134, p = 0.06, 26 ± 5.4 vs 63 ± 27.3, p = 0.02 y 14.5 ± 11.1 vs 88 ± 54, p = 0.0001 respectively).
Conclusions: Estradiol levels at admittance › 45 pg/mL are associated with mortality in our critically ill patients; other biomarkers were not significantly related.

REFERENCES

1. Wichmann M, Inthorn D, Andress H, et al. Incidence and mortality of severe sepsis in surgical intensive care patients: The influence of patient gender on disease process and outcome. Intensive Care Med 2000;26(2):167-172.

2. Angstwurm MW, Gaertner R, Schopohl J. Outcome in elderly patients with severe infection is influenced by sex hormones but not gender. Crit Care Med 2005;33(12):2786-93.

3. Adrie C, Azoulay E, Francais A. Influence of gender on the outcome of severe sepsis. Chest 2007;132:1786-1793.

4. Berkowitz D, Martin G. Sepsis and sex. Chest 2007; 132:1725-1727. May Addison MD, Dossett Lesly MD, Norris Patrick MD, et al. Estradiol is associated with mortality in critically ill trauma and surgical patients. Crit Care Med 2008;36(1):62-68.

5. Dosset L, Swenson B, Heffernan D, et al. High levels of endogenous estrogens are associated with death in the critically injured adult. J Trauma 2008;64:580-585.

6. Bengtsson AK, Ryan EJ, Giordano D, et al. 17Beta-estradiol (E2) modulates cytokine and chemokine expression in human monocyte-derived dendritic cells. Blood 2004;104:1404-1410.

7. Straub R. The complex role of estrogens in inflammation. Endocrine Reviews 2007;28(5):521-574.

8. Bengtsson A, Ryan E, Giordano D, et al. 17 b estradiol (E2) modulates cytokine and chemokine expression in human monocyte – derived dendritic cells. Blood 2004; 104:1404-1410.

9. Eickels M, Patten R, Aronovitz M, et al. 17 b estradiol increases cardiac remodeling and mortality in mice with myocardial infarction. JAAC 2003;41(11):2084-2092.

10. Trotter A, Muck K, Grill H, et al. Gender – related plasma levels of progesterone, interleukin-8 and interleukin-10 during and after cardiopulmonary bypass in infants and children. Crit Care 2001;5:343-348.

11. Abbott R, Launer L, Rodriguez B. Serum estradiol and risk of stroke in elderly men. Neurology 2007;68:563-568.

12. Jankowska E, Rozentryt P, Ponikowska B, et al. Circulating estradiol and mortality in men with systolic chronic heart failure. JAMA 2009;301(18):1892-1901.

13. Spratt DI, Morton JR, Kramer RS, et al. Increases in serum estrogen levels during major illness are caused by increased peripheral aromatization. Am J Physiol Endocrinol Metab 2006;291:E631-E638.