Pro‐ and Anti‐Inflammatory Responses and Clinical Outcomes in Critically Ill Patients With Endotheliopathy: A Cohort Study
Authors' conclusion
In this cohort of critically ill ICU patients, endotheliopathy was associated with (1) higher levels of pro- and anti-inflammatory biomarkers at ICU admission and (2) MODS, single organ failure, and 30-day all-cause mortality. Among the three endotheliopathy biomarkers, sTM demonstrated the most consistent and strongest associations with both inflammatory biomarkers and clinical outcomes.
Study context
- Population
- Critically ill intensive care unit (ICU) patients
- Participants
- 459 patients
- Comparison
- Endotheliopathy biomarkers (syndecan-1, soluble thrombomodulin (sTM), PECAM-1) vs inflammatory biomarkers and clinical outcomes
- Primary endpoint
- Associations of endotheliopathy biomarkers with pro- and anti-inflammatory biomarkers at ICU admission and with 30-day clinical outcomes
- Follow-up
- 30 days
Methodological detailsexplorative, single-centre
- Explorative
- Single-centre
Primary result
As reported in the abstract
Associations of endotheliopathy biomarkers with inflammatory biomarkers and clinical outcomes
- Higher levels of all three endotheliopathy biomarkers associated with higher inflammatory biomarker levels; PECAM-1 not significantly associated with IFN-ϒ, IL-1β and IL-12p70
- All three endotheliopathy biomarkers significantly associated with increased mean and maximum modified Sequential Organ Failure Assessment (mSOFA) scores over 30 days, renal, hepatic and coagulation failure, and 30-day all-cause mortality
- Only sTM significantly associated with cardiovascular failure; none significantly associated with respiratory failure
- sTM showed the strongest associations with inflammatory biomarkers, mSOFA increases, organ failure and 30-day mortality vs syndecan-1 and PECAM-1
- Adjusted for age, sex, septic shock, pre-ICU surgery and chronic disease
- IL-4 excluded from linear regression (> 50% imputed values)
Original publication
Pro‐ and Anti‐Inflammatory Responses and Clinical Outcomes in Critically Ill Patients With Endotheliopathy: A Cohort Study. Acta Anaesthesiol Scand. Published 8 September 2025. doi:10.
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