Table 1.
Baseline characteristics and nutritional status of septic patients according to plasma TMAO concentration
| Low TMAO (< 0.4 μmol/L) N = 32 |
Median TMAO (0.4–2.5 μmol/L) N = 32 |
High TMAO (≥ 2.5 μmol/L) N = 31 |
p value |
|
|---|---|---|---|---|
| Age (years) | 68.5 (61.3–79.5) | 67.5 (56.3–74.8) | 70.0 (57.0–78.0) | 0.371 |
| Male gender | 17 (53.1) | 18 (56.3) | 23 (74.2) | 0.182 |
| Smoking | 3 (9.4) | 6 (18.2) | 10 (32.3) | 0.074 |
| Disease severity | ||||
| APACHE II scores | 29 (28.0–31.0) | 28.0 (23.3–31.0) | 29.0 (24.0–32.0) | 0.742 |
| SOFA scores | 12.0 (10.0–12.8) | 11.0 (9.0–13.8) | 11.0 (9.0–12.0) | 0.662 |
| Mean arterial pressure (mmHg) | 56.7 (50.3–63.5) | 58.3 (50.2–65.0) | 53.0 (46.3–61.3) | 0.163 |
| Septic shock | 14 (43.8) | 12 (37.5) | 8 (25.8) | 0.322 |
| Causes & treatment of sepsis | ||||
| Respiratory tract infection | 26 (81.3) | 24 (75.0) | 26 (83.9) | 0.663 |
| Urinary tract infection | 0 (0.0) | 3 (9.4) | 3 (9.7) | 0.196 |
| Intra-abdominal infection | 8 (25.0) | 7 (21.9) | 3 (9.7) | 0.262 |
| Bloodstream infection | 17 (53.1) | 17 (53.1) | 9 (29.0) | 0.087 |
| Abx pre-treatment, numbers | 5.5 (3.0–7.0) | 3.0 (2.3–4.8) | 2.0 (1.0–3.0) | < 0.001 |
| Abx pre-treatment, days | 12.5 (3.3–27.8) | 3.0 (2.0–10.0) | 1.0 (1.0–4.0) | < 0.001 |
| Co-morbidities | ||||
| Hypertension | 9 (28.1) | 13 (40.6) | 15 (48.4) | 0.250 |
| Diabetic mellitus | 7 (21.9) | 8 (25.0) | 8 (25.8) | 0.928 |
| Heart failure | 4 (12.5) | 2 (6.3) | 2 (6.5) | 0.594 |
| COPD | 3 (9.4) | 3 (9.4) | 1 (3.2) | 0.561 |
| Cirrhosis | 2 (6.3) | 3 (9.4) | 0 (0.0) | 0.238 |
| Prior CAD | 1 (3.1) | 2 (6.3) | 8 (25.8) | 0.010 |
| Prior stroke or PAD | 1 (3.1) | 1 (3.1) | 5 (16.1) | 0.075 |
| Malignancy | 20 (62.5) | 15 (46.9) | 14 (45.2) | 0.313 |
| Autoimmune disease | 2 (6.3) | 6 (18.6) | 4 (12.9) | 0.322 |
| Laboratory data | ||||
| White blood cells (K) | 9.0 (3.3–15.0) | 9.6 (1.1–16.2) | 8.6 (2.1–12.4) | 0.906 |
| Hemoglobin (mg/dL) | 8.6 (7.7–9.3) | 8.8 (7.7–10.0) | 8.4 (7.6–9.8) | 0.722 |
| eGFR (mL/min/1.73m2) | 57.4 (26.4–90.3) | 43.0 (21.8–78.9) | 21.5 (7.4–35.2) | 0.001 |
| Total bilirubin (mg/dL) | 1.8 (0.7–3.1) | 1.7 (0.8–4.5) | 0.8 (0.4–1.7) | 0.008 |
| Glucose (mg/dL) | 132.0 (97.8–205.8) | 133.0 (101.3–204.0) | 147.0 (107.0–228.0) | 0.697 |
| Lactate (mg/dL) | 18.3 (8.3–25.4) | 16.7 (9.9–24.1) | 10.8 (7.2–19.8) | 0.268 |
| C-reactive protein (mg/dL) | 7.5 (3.0–13.4) | 12.2 (6.9–19.3) | 13.5 (5.9–25.0) | 0.030 |
| TMAO (μmol/L) | 0.1 (0.1–0.2) | 1.1 (0.7–1.9) | 4.7 (3.5–11.0) | < 0.001 |
| Nutritional status | ||||
| Enteral intake of calories (kcal/day) | 89.5 (0.0–623.5) | 502.0 (0.0–768.9) | 1355.5 (1055.0–1573.0) | < 0.001 |
| Enteral intake of protein (g/day) | 3.5 (0.0–25.9) | 20.0 (0.0–38.4) | 61.0 (35.0–71.0) | < 0.001 |
| Total calories (% of target) | 30.9 (12.6–51.8) | 43.5 (27.9–68.0) | 81.7 (67.1–110.3) | < 0.001 |
| Total protein (% of target) | 14.6 (0.0–53.1) | 32.0 (0.0–59.0) | 66.9 (55.4–86.2) | < 0.001 |
| Body mass index | 19.3 (17.7–20.3) | 21.3 (18.7–25.2) | 23.9 (22.4–28.6) | < 0.001 |
| Albumin (mg/dL) | 2.8 (2.6–3.2) | 2.9 (2.5–3.2) | 3.3 (2.9–3.8) | 0.001 |
| Prealbumin (mg/dL) | 6.9 (4.4–10.9) | 7.7 (5.4–13.1) | 12.0 (8.3–17.0) | 0.001 |
| Nutrition risk index | 80.1 (73.8–85.5) | 84.5 (78.5–92.4) | 98.3 (87.3–109.8) | < 0.001 |
| NRS 2002 scores | 5.0 (5.0–6.0) | 4.0 (4.0–5.8) | 4.0 (3.0–4.0) | < 0.001 |
TMAO trimethylamine-N-oxide; APACHE Acute Physiology and Chronic Health Evaluation; SOFA Sequential Organ Failure Assessment; Abx antibiotic; COPD chronic obstructive pulmonary disease; CAD coronary artery disease; PAD peripheral arterial disease; eGFR estimated glomerular filtration rate; NRS-2002 Nutritional Risk Screening 2002