Skip to content


Critical Care

Open Access

Serum pro-metalloproteinase 9 is a predictor of length of ICU and hospital stay in patients with septic shock

  • NA Costa1,
  • AF Gonçalves1,
  • BPM Rafacho1,
  • AL Gut1,
  • PS Azevedo1,
  • LAM Zornoff1,
  • SAR Paiva1 and
  • MF Minicucci1
Critical Care201317(Suppl 3):P54

Published: 19 June 2013


The matrix metalloproteinases (MMPs) participate in fundamental processes, such as cell proliferation, differentiation, adhesion, migration, angiogenesis, apoptosis, and inflammation [1]. The increased expression of MMPs suggests that these proteases may influence the pathogenesis of endotoxemia in sepsis [2]. The objective of this study was to evaluate the serum activity of MMP-2 and MMP-9, length of hospital stay, length of ICU stay and mortality in patients with septic shock.


This prospective study included all patients with septic shock on admission or during ICU stay, over the age of 18 years, admitted to the ICU from March to July 2012. Demographic information, clinical evaluation and blood samples were taken within the first 72 hours of the patient's admission or within 72 hours after septic shock diagnosis for laboratory analysis and MMP-2 and MMP-9 activity. The activity of MMPs was performed by zymography. The level of significance was set at 5%.


We evaluated 67 patients with a mean age of 56 ± 15 years, 66% male, the median length of ICU and hospital stay was 9 (4 to 15) and 16 (10 to 29) days, respectively, and the ICU mortality rate was 61%. Higher values of APACHE II, SOFA, lactate and urea, and lower values of albumin, length of ICU and hospital stay were associated with ICU mortality. In univariate analysis, serum activity of MMP-2 and MMP-9 were not associated with length of ICU, hospital stay and mortality in septic shock patients. However, in the regression model analysis when adjusted for sex, age, lactate and APACHE II, the activity of pro-MMP-9 was negatively associated with the length of ICU (coefficient: -0.016; P = 0.028) and hospital (coefficient: -0.015; P = 0.041) stay, but was not associated with ICU mortality (OR: 1.051; 95% CI: 0.950 to 1.163; P = 0.332).


Serum activity of pro-MMP-9 was negatively associated with length of ICU and hospital stay in patients with septic shock.



Supported by CAPES.

Authors’ Affiliations

Botucatu Medical School, UNESP, Rubião Júnior, Botucatu, Brazil


  1. Le NT, Xue M, Castelnoble LA, Jackson CJ: The dual personalities of matrix metalloproteinases in inflammation. Front Biosci 2007, 12: 1475-1487. 10.2741/2161View ArticlePubMedGoogle Scholar
  2. Vanlaere I, Libert C: Matrix metalloproteinases as drug targets in infections caused by gram-negative bacteria and in septic shock. Clin Microbiol Rev 2009, 22: 224. 10.1128/CMR.00047-08PubMed CentralView ArticlePubMedGoogle Scholar


© Costa et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.