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

Abstract 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 μg/mL [2.9–6.1] vs. 2.5 μg/mL [2.1–5.0], P = 0.019 at admission; 4.3 μg/mL [3.3–5.2] vs. 3.2 μg/mL [2.2–3.8], P = 0.004 at 24 h; 3.1 μg/mL [2.5–4.2] vs. 2.3 μg/mL [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, 0.29; 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