ArticleMedizinische Klinik, Intensivmedizin und Notfallmedizin2017
Serum IgG levels and mortality in patients with severe sepsis and septic shock : The SBITS data.
Article in Medizinische Klinik, Intensivmedizin und Notfallmedizin, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Systematic review and meta-analysis of humoral immunity proteins and mortality in sepsis.Critical care (London, England) · 2025Pooled it
- Targeting sepsis through inflammation and oxidative metabolism.World journal of critical care medicine · 2025Review
- Nonlinear Association Between Calculated Globulin Levels and 28-Day Mortality in Patients with Sepsis: A Retrospective Cohort Study.Risk management and healthcare policy · 2025Article
- Longitudinal assessment of immunoglobulin response and disease progression in critically ill patients with community acquired pneumonia.Critical care (London, England) · 2024Article
- Neutrophil Depletion Changes the N-Glycosylation Pattern of IgG in Experimental Murine Sepsis.International journal of molecular sciences · 2024Article
- Nomogram predictive model for in-hospital mortality risk in elderly ICU patients with urosepsis.BMC infectious diseases · 2024Article
- Destabilisation of T cell-dependent humoral immunity in sepsis.Clinical science (London, England : 1979) · 2024Review
- Review
- The impact of TLR2 and aging on the humoral immune response to Staphylococcus aureus bacteremia in mice.Scientific reports · 2023Article
- Clinical efficacy of IgM-enriched immunoglobulin as adjunctive therapy in neonatal and pediatric sepsis: a systematic review and meta-analysis.Frontiers in pediatrics · 2023Review
- Prediction of short-term mortality in elderly patients with sepsis using immunoglobulin G2: An observational study.Heliyon · 2022Article
- Sepsis-induced immunosuppression: mechanisms, diagnosis and current treatment options.Military Medical Research · 2022Review
- Risk factor analysis and nomogram for predicting in-hospital mortality in ICU patients with sepsis and lung infection.BMC pulmonary medicine · 2022Article
- Advances in Immune Monitoring Approaches for Sepsis-Induced Immunosuppression.Frontiers in immunology · 2022Review
- Higher levels of IgA and IgG at sepsis onset are associated with higher mortality: results from the Albumin Italian Outcome Sepsis (ALBIOS) trial.Annals of intensive care · 2021Article
- Comparison of Total Immunoglobulin G in Ante- and Postmortem Blood Samples from Tissue Donors.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2021Article
- SerumJournal of clinical medicine · 2021Article
- Intravenous immunoglobulin fails to improve ARDS in patients undergoing ECMO therapy.Journal of intensive care · 2018Article
- The protective association of endogenous immunoglobulins against sepsis mortality is restricted to patients with moderate organ failure.Annals of intensive care · 2017Article
- The Role of Adjunctive Therapies in Septic Shock by Gram Negative MDR/XDR Infections.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2017Review
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe role of intravenous immune globulin (Ig) therapy in patients with severe sepsis and septic shock is discussed controversially. Low initial IgG levels could help to identify those patients who might benefit from an adjunctive Ig treatment.
objectivesTo investigate the effect of initial serum IgG levels on 28-day mortality in patients with severe sepsis and septic shock. MATERIALS AND
methodsIn this retrospective analysis of the SBITS trial data, 543 patients were allocated to four groups (quartiles) depending on their initial serum IgG levels (1: IgG ≤ 6.1 g/l; 2: IgG 6.2-8.4 g/l; 3: IgG 8.5-11.9 g/l; 4: IgG > 11.9 g/l). The third quartile was taken as the reference quartile. For the applied logistic regression model clinically relevant confounders were defined and integrated into further risk-adjusted calculations.
resultsPatients with the lowest IgG levels had a mortality rate similar to those patients with initial IgG levels in the second and third quartile, representing the physiological IgG range in healthy people. Surprisingly, patients with the highest IgG levels even showed a significantly higher mortality in a risk-adjusted calculation compared to the reference quartile (OR 1.69, CI 1.01-2.81, p = 0.05). Subgroup analyses revealed that initial IgG levels were of no prognostic value in patients presenting with vasopressor-dependent septic shock on admission as well as in patients with either gram-positive or gram-negative sepsis.
conclusionsInitially low IgG levels do not discriminate between survival and nonsurvival in patients with severe sepsis and septic shock. Therefore, low IgG cannot help to identify those patients who might benefit from an adjunctive IgG sepsis therapy. Whether a high initial IgG serum level is an independent mortality risk factor needs to be investigated prospectively.
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