Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital

Profound Endothelial Damage Predicts Impending Organ Failure and Death in Sepsis

Research output: Contribution to journalJournal articleResearchpeer-review


  1. Hemostasis in Pediatric Cardiac Surgery

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Pregnancy and Antiphospholipid Syndrome

    Research output: Contribution to journalReviewResearchpeer-review

  3. Nordic Haemophilia Council's practical guidelines on diagnosis and management of von Willebrand disease

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. How to RESPOND to Modern Challenges for People Living with HIV: A Profile for a New Cohort Consortium

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Compassionate Use of Remdesivir in Covid-19

    Research output: Contribution to journalLetterResearchpeer-review

View graph of relations

Endothelial damage contributes to organ failure and mortality in sepsis, but the extent of the contribution remains poorly quantified. Here, we examine the association between biomarkers of superficial and profound endothelial damage (syndecan-1 and soluble thrombomodulin [sTM], respectively), organ failure, and death in sepsis. The data from a clinical trial, including critically ill patients predominantly suffering sepsis ( NCT00271752) were studied. Syndecan-1 and sTM levels at the time of study enrollment were determined. The predictive ability of biomarker levels on death and organ failures during follow-up were assessed in Cox models adjusted for potential confounders including key organ dysfunction measures assessed at enrollment. Of the 1,103 included patients, 418 died. sTM levels at the time of enrollment independently predicted risk of death in adjusted models (hazard ratio [HR] [highest quartile > 14 ng/mL vs. lowest quartile < 7 ng/mL] 2.2 [95% confidence interval [CI]: 1.2-4.0], p = 0.02, respectively). Conversely, syndecan-1 levels failed to predict death (adjusted HR [> 240 vs. < 70 ng/mL] 1.0 [95% CI: 0.6-1.5], p = 0.67). sTM but not syndecan-1 levels at enrollment predicted risk of multiple organ failure during follow-up (HR [> 14 ng/mL vs. < 7 ng/mL] 3.5 [95% CI: 1.5-8.3], p = 0.005 and 2.0 [95% CI: 0.8-5.0], p = 0.1321, respectively). Profound damage to the endothelium independently predicts risk of multiple organ failure and death in septic patients. Our findings also suggest that the detrimental effect of profound endothelial damage on risk of death operates via mechanisms other than causing organ failures per se. Therefore, damage to the endothelium appears centrally involved in the pathogenesis of death in sepsis and could be a target for intervention.

Original languageEnglish
JournalSeminars in Thrombosis and Hemostasis
Issue number1
Pages (from-to)16-25
Number of pages10
Publication statusPublished - Feb 2015

ID: 44914369