Plasma fibronectin concentration in suspected septicaemia is related to severity of sepsis

Low plasma fibronectin levels have been reported in patients with septic complications following surgery, major trauma or burn injury. Our purpose was to evaluate fibronectin in suspected septicaemia and its relationship to severity of infection and clinical outcome. In 51 consecutive patients with infection classified as mild (group A), severe (group B) or severe complicated by septic shock, disseminated intravascular coagulation or multiple organ failure (group C), the respective mean initial fibronectin concentrations were 85% +/- 10 (SD), 55% +/- 15 and 44% +/- 13 of the reference mean (0.35 g/l). In statistical analysis the groups differed significantly from each other and from controls. All 11 patients with mild infection had fibronectin values above the lower reference limit, which was 60%, whereas in 15 of 16 group C patients and all seven fatal cases in that group the initial fibronectin values were below 60%. Plasma fibronectin rose with clinical improvement, but remained low in patients with persisting septicaemia. The results confirmed earlier reports of low fibronectin levels in septic states, and indicate that low concentration is of prognostic value and is related to the severity of the disease.