Relationship between changes in serum estrone levels and outcome in human males with septic shock

The effect of septic shock on the production of estrogens, other steroid hormones, and gonadotropins in men was investigated. Two groups of male patients in the early septic shock were studied over 3 days following their admission to the Intensive Care Unit. Group I (n = 9) patients recovered and group II (n = 6) patients died. The simplified acute physiological score was 13.5 +/- 1.5 for group I and 21.2 +/- 2.3 for group II (P less than .05). In group I patients, estrogen levels (particularly E1) were high on day 1 and decreased progressively (day 1: 3,515 +/- 884 pmol/L, day 2: 2,450 +/- 292 pmol/L, and day 3: 1,043 +/- 255 pmol/L). In group II patients, estrone levels were as high as in group I on day 1, but increased throughout the 3 days (day 1: 3,250 +/- 1,200 pmol/L, day 2: 4,495 +/- 930 pmol/L, and day 3: 6,123 +/- 966 pmol/L). There were few changes in gonadotropins and other steroid hormones, except that the testosterone levels were below normal in both patient groups, while cortisol was elevated in group II. The changes in serum E1 may provide an accurate marker of individual outcome.