Catecholamine concentration as a predictor of mortality in emergency surgical patients

Abstract

Background: Trauma and emergency surgery are major causes of morbidity and mortality. The objective of this study was to determine whether serum levels of epinephrine and norepinephrine are associated with aging and mortality. Methods: This was a prospective observational cohort study conducted in the surgical critical care unit. We included 90 patients who were admitted for postoperative care, because of major trauma, or both. We collected demographic and clinical variables, and the serum levels of epinephrine and norepinephrine. Results: For patients in the > 60-year age group, the use of vasoactive drugs was found to be associated with undetectable levels of epinephrine, (OR [95% CI] = 6.36 [1.12, 36.08]), p = 0.05). For the patients with an undetectable level of epinephrine, the in-hospital mortality was higher among patients with a norepinephrine level ≥ 2006.5 pg/mL (OR [95% CI] = 4.00 [1.27, 12.58]), p = 0.03). Conclusions: There is an association between age and mortality. Undetectable serum epinephrine, which is more common in older patients, could contribute to poor outcomes.