Poor Prognosis of Patients with Septic Shock Associated with Low Serum Selenium Levels

ABSTRACT

PURPOSE: To investigate whether or not low clinical serum selenium levels are associated with survival prognosis for septic shock patients. METHODS: This was a prospective, observational study conducted in an emergency Intensive Care Unit (ICU) at a tertiary referral hospital in Korea. We enrolled consecutive, septic shock patients who were admitted to the ICU from March 2008 to February 2010. We collected patient data with respect to demographics, infection sites, pathogens, serum lactate levels, central venous oxygen saturations, and serum selenium levels at the time of ICU admission. We also collected data with respect to 6-hour early goal achievement, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, mechanical ventilator or renal replacement therapy application, and steroid administration. Using a 28-day mortality criterion, enrolled patients were divided into two groups: survivors and non-survivors. Resulting data was compared between the two groups. RESULTS: Among 115 patients, 81 were the survivors and 34 were non-survivors. Lower serum selenium levels (odds ratio [OR]=0.945, 95% confidence intervals [CI], 0.908-0.984, p=0.006) and higher APACHE II scores (OR=1.096, 95% CI, 1.006-1.195, p=0.036) were independently associated with 28-day patient mortality results. The cutoff serum selenium level was 47.5 microg/L (sensitivity 0.80, specificity 0.71, area under curve=0.745) for 28-day mortality. CONCLUSION: Serum selenium levels of 47.5 microg/L or lower are associated with 28-day mortality for septic shock patients.