{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:45:45Z","timestamp":1790790345665,"version":"4.1.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Thromb Hemost"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:p>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 (Clinicaltrials.gov: 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\u2009&gt;\u200914 ng\/mL vs. lowest quartile\u2009&lt;\u20097 ng\/mL] 2.2 [95% confidence interval [CI]: 1.2\u20134.0], p\u2009=\u20090.02, respectively). Conversely, syndecan-1 levels failed to predict death (adjusted HR [&gt; 240 vs.\u2009&lt;\u200970 ng\/mL] 1.0 [95% CI: 0.6\u20131.5], p\u2009=\u20090.67). sTM but not syndecan-1 levels at enrollment predicted risk of multiple organ failure during follow-up (HR [&gt; 14 ng\/mL vs.\u2009&lt;\u20097 ng\/mL] 3.5 [95% CI: 1.5\u20138.3], p\u2009=\u20090.005 and 2.0 [95% CI: 0.8\u20135.0], p\u2009=\u20090.1321, 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.<\/jats:p>","DOI":"10.1055\/s-0034-1398377","type":"journal-article","created":{"date-parts":[[2015,1,15]],"date-time":"2015-01-15T18:38:48Z","timestamp":1421347128000},"page":"016-025","source":"Crossref","is-referenced-by-count":95,"title":["Profound Endothelial Damage Predicts Impending Organ Failure and Death in Sepsis"],"prefix":"10.1055","volume":"41","author":[{"given":"Maria","family":"Johansen","sequence":"additional","affiliation":[{"name":"CHIP, Department of Infectious Diseases and Rheumatology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4r","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Texas Medical School at Houston, Houston, Texas"},{"name":"Section for Transfusion Medicine, Capital Region Blood Bank, Rigshospitalet, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sisse","family":"Ostrowski","sequence":"additional","affiliation":[{"name":"Section for Transfusion Medicine, Capital Region Blood Bank, Rigshospitalet, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Bestle","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care at Nordsjaellands Hospital, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Hein","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care at Nordsjaellands Hospital, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care at University Hospital Glostrup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"S\u00f8e-Jensen","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care at University Hospital Herlev, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mads","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care at University Hospital Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Steensen","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care at University Hospital Hvidovre, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Mohr","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care at University Hospital Gentofte, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Thormar","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care at University Hospital Bispebjerg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina","family":"Lundgren","sequence":"additional","affiliation":[{"name":"Centre of Diagnostic Investigations, Rigshospitalet, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Cozzi-Lepri","sequence":"additional","affiliation":[{"name":"CHIP, Department of Infectious Diseases and Rheumatology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"},{"name":"Department of Virology, Royal Free and University College Medical School London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Lundgren","sequence":"additional","affiliation":[{"name":"CHIP, Department of Infectious Diseases and Rheumatology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens-Ulrik","family":"Jensen","sequence":"additional","affiliation":[{"name":"CHIP, Department of Infectious Diseases and Rheumatology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"},{"name":"Department of Clinical Microbiology at Copenhagen University Hospital Hvidovre, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2015,1,15]]},"container-title":["Seminars in Thrombosis and Hemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0034-1398377.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T13:19:33Z","timestamp":1557148773000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0034-1398377"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1,15]]},"references-count":0,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2015,2,2]]},"published-print":{"date-parts":[[2015,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0034-1398377","relation":{},"ISSN":["0094-6176","1098-9064"],"issn-type":[{"value":"0094-6176","type":"print"},{"value":"1098-9064","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1,15]]}}}