Background: Soluble CD40 ligand (sCD40L) exhibits proinflammatory and procoagulant effects. Recent data indicated that sCD40L plays a significant role in septic patients. The aim of the present study was to determine sCD40L changes in surgical patients without sepsis (SWS) and in surgical sepsis patients (SS) during the first three days at intensive care unit (ICU) admission and to observe the association between sCD40L and mortality.
Methods: Time changes in sCD40L levels were assessed for 3 days after ICU admission in 49 patients with SS and compared with 19 SWS patients. Serum sCD40L concentration was detected by ELISA. Survival at 28 days was used as the endpoint.
Results: SS had significantly higher sCD40L levels than SWS and control patients. We observed an association between sCD40L levels ≥1028.75 pg/ml at day 2 and 28-day mortality (odds ratio = 7.888; 95% confidence interval = 1.758 to 35.395; P= 0.007). We could not discover any significant differences in gender, presence of septic shock, site of infection, length of stay in the ICU, PaO2/FiO2 ratio, incidence of AKI, ARDS, or type of surgery between nonsurvivors and survivors.
Conclusions: Septic patients show persistently higher circulating sCD40L levels in the first three days at ICU admission, and the serum sCD40L levels are associated with the mortality of patients with sepsis; thus, serum sCD40L may be used as a reliable biomarker and therapeutic target in sepsis.