ArticleMediators of inflammation2018
A Sustained Reduction in Serum Cholinesterase Enzyme Activity Predicts Patient Outcome following Sepsis.
Article in Mediators of inflammation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Butyrylcholinesterase Activity as a Mortality Marker in ICU Patients: An Individual Participant Data Meta-Analysis.Critical care explorations · 2026Pooled it
- Dynamic Changes in Serum Choline Acetyltransferase and Acetylcholinesterase in Septic versus Non-Septic ICU Patients: A Prospective Exploratory Study.Journal of inflammation research · 2026Trial
- In a secondary analysis from a randomised, double-blind placebo-controlled trial Dexmedetomidine blocks cholinergic dysregulation in delirium pathogenesis in patients with major surgery.Scientific reports · 2023Trial
- Serum cholinesterase as a prognostic marker in respiratory critical illness: a narrative review.Wiener klinische Wochenschrift · 2026Review
- Low plasma butyrylcholinesterase activity in dogs: prevalence, association with underlying disorders, laboratory variables, and survival.Journal of veterinary internal medicine · 2026Article
- Monocyte-Containing Inflammatory Indices Show Stronger Association with 30-Day Mortality than the Systemic Immune-Inflammation Index in Elderly Sepsis: A Single-Center Retrospective Observational Cohort Study.Journal of clinical medicine · 2026Article
- The incremental prognostic value of platelet-to-neutrophil and platelet-to-lymphocyte ratios in patients with sepsis: A retrospective cohort study.The Journal of international medical research · 2026Article
- Expanding cholinesterase function: kinetic and structural evidence for hydrolysis of long-chain fatty-acid esters.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Lower butyrylcholinesterase is associated with postoperative delirium in adult cardiac surgery patients: a secondary analysis of two prospective studies.BMC anesthesiology · 2026Article
- Risk Factors for Postoperative Wound Infections in Patients with Brain Tumors Without Anticoagulant or Antiplatelet Therapy: A Ten-Year Single-Center Retrospective Analysis.Journal of clinical medicine · 2026Article
- Serum butyrylcholinesterase activity as a predictor of severity and mortality in COVID-19 patients.Scientific reports · 2025Article
- Assessing infection related to short-term central venous catheters in the perioperative setting.Scientific reports · 2025Observational
- New views on physiological functions and regulation of butyrylcholinesterase and potential therapeutic interventions.Frontiers in molecular biosciences · 2025Review
- Analysis of the association between cholinesterase and in-hospital mortality in children with bloodstream infections in the pediatric intensive care unit.Frontiers in pediatrics · 2025Article
- Monitoring Immune Dysfunction in Critically Ill Patients with Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2024Article
- Reduced preoperative serum choline esterase levels and fecal peritoneal contamination as potential predictors for the leakage of intestinal sutures after source control in secondary peritonitis.World journal of emergency surgery : WJES · 2024Article
- Emerging significance of butyrylcholinesterase.World journal of experimental medicine · 2024Review
- Cholinesterase activities and sepsis-associated encephalopathy in viral versus nonviral sepsis.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Article
- Perioperative point-of-care-testing of plasmacholinesterases identifies older patients at risk for postoperative delirium: an observational prospective cohort study.BMC geriatrics · 2024Observational
- Butyrylcholinesterase levels correlate with surgical site infection risk and severity after colorectal surgery: a prospective single-center study.Frontiers in surgery · 2024Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Early sepsis identification is of paramount importance for an effective therapy and the patient outcome; however, a suitable prognostic biomarker is lacking. Anti-inflammatory nonneuronal cholinergic signaling modulates the magnitude of an immune response. Serum cholinesterase (BChE), an enzyme that hydrolyzes acetylcholine, plays an important role during inflammatory response and serves as an accurate index of cholinergic activity. BChE activity was measured in septic patients using a point-of-care system, and levels of conventional inflammatory markers and the disease severity scores were obtained. We observed a strong, sustained reduction in BChE activity in patients who died within a 90-day observation period, as compared to survivors. Reduced BChE activity when measured at the ICU admission effectively differentiated between the 90-day survivor and the nonsurvivor patient groups. We estimated a critical BChE level of 1.661 kU/L (CI 0.5-0.8, 94% sensitivity, 48% specificity, AUC 0.7) to best predict patient outcome providing a benchmark criterion for early detection of potentially fatal sepsis measured at the admission. This finding suggests that the BChE activity, used in combination with the laboratory tests, clinical examination, and the disease severity scoring, could serve to identify high-risk patients at the ICU admission, the most critical time point in the sepsis treatment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.