• Leonardo Lorente, María M Martín, Antonia Pérez-Cejas, Agustín F González-Rivero, Mónica Argueso, Luis Ramos, Jordi Solé-Violán, Juan J Cáceres, Alejandro Jiménez, and Victor García-Marín.
• Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n. La Laguna, 38320 Santa Cruz de Tenerife, Spain. Electronic address: lorentemartin@msn.com.
• J Crit Care. 2020 Jun 1; 57: 1-4.

PurposePreviously our team found higher serum substance P concentrations at day 1 of a malignant middle cerebral artery infarction (MMCAI) in non-surviving than in surviving patients. Thus, the objective of this study was to determine whether serum substance P levels during the first week of MMCAI could predict mortality.MethodsWe included patients with MMCAI defined as computed tomography findings of acute infarction in at least of 50% of the territory and Glasgow Coma Scale ≤8. We determined serum concentrations of substance P on days 1, 4 and 8 of MMCAI. Thirty-day mortality was the study end-point.ResultsSerum substance P concentrations at days 1 (p < .001), 4 (p < .001), and 8 (p = .001) of MMCAI in non-surviving (n = 34) were higher than in surviving patients (n = 34). Receiver operating characteristic analyses showed that serum substance P concentrations at days 1, 4, and 8 of MMCAI had an area under curve (95% confidence intervals) to predict 30-day mortality of 0.77 (0.66-0.87; p < .001), 0.82 (0.69-0.91; p < .001) and 0.85 (0.72-0.94; p < .001) respectively.ConclusionsThe two new findings of our study are that non-surviving MMCAI patients showed higher serum substance P levels at day 1, 4 and 8 than surviving, and that those levels could predict 30-day mortality.Copyright © 2020 Elsevier Inc. All rights reserved.

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