Point-of-Care Serum Proenkephalin as an Early Predictor of Mortality in Patients Presenting to the Emergency Department with Septic Shock.

Autor:	Verras C; University Emergency Department, Attikon University Hospital, 12462 Athens, Greece., Bezati S; University Emergency Department, Attikon University Hospital, 12462 Athens, Greece., Bistola V; 2nd Cardiology Department, Attikon University Hospital, 12462 Athens, Greece., Ventoulis I; Department of Occupational Therapy, University of Western Macedonia, 50200 Ptolemaida, Greece., Matsiras D; University Emergency Department, Attikon University Hospital, 12462 Athens, Greece., Tsiodras S; 4th Department of Internal Medicine, Attikon University Hospital, 12462 Athens, Greece., Parissis J; University Emergency Department, Attikon University Hospital, 12462 Athens, Greece., Polyzogopoulou E; University Emergency Department, Attikon University Hospital, 12462 Athens, Greece.
Jazyk:	angličtina
Zdroj:	Biomedicines [Biomedicines] 2024 May 02; Vol. 12 (5). Date of Electronic Publication: 2024 May 02.
DOI:	10.3390/biomedicines12051004
Abstrakt:	Background: The aim of the present study is to investigate the prognostic utility of point-of-care (POC)-measured proenkephalin (PENK), a novel biomarker, in terms of predicting in-hospital mortality in patients presenting to the emergency department (ED) with septic shock. Methods: Bedside PENK was measured in consecutive patients presenting to the ED with septic shock according to the Sepsis-3 clinical criteria. The association of PENK with inflammatory and routine biomarkers, and its role as a predictor of in-hospital mortality, was examined. Results: Sixty-one patients with septic shock [53% females, median age 83 years (IQR 71-88)] were evaluated. Median (IQR) values of creatinine, plasma lactate, soluble urokinase plasminogen activator receptor (SuPAR), procalcitonin and PENK were 1.7 (1.0-2.9) mg/dL, 3.6 (2.1-6.8) mmol/L, 13.1 (10.0-21.4) ng/mL, 2.06 (0.84-3.49) ng/mL, and 205 (129-425) pmol/L, respectively. LogPENK significantly correlated with LogLactate (rho = 0.369, p = 0.004), LogCreatinine (rho = 0.537, p < 0.001), LogProcalcitonin (rho = 0.557, p < 0.001), and LogSuPAR (rho = 0.327, p = 0.011). During hospitalization, 39/61 (64%) patients died. In a multivariable logistic regression model, logPENK was an independent predictor of in-hospital mortality (OR 11.9, 95% CI: 1.7-84.6, p = 0.013). Conclusion: POC PENK levels measured upon presentation to the ED strongly correlated with metabolic, renal and inflammatory biomarkers, and may serve as a predictor of in-hospital mortality in patients with septic shock.
Databáze:	MEDLINE
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