Prognostic significance of APACHE II score and plasma suPAR in Chinese patients with sepsis: a prospective observational study

Autor: Shuming Pan, Hairong Wang, Aihua Fei, Qinmin Ge, Xuan Liu, Zhihua Li, Yong Shen
Rok vydání: 2015
Předmět:
Acute Physiology and Chronic Health Evaluation II (APACHE II)
Male
medicine.medical_specialty
Time Factors
Soluble urokinase plasminogen activator receptor (suPAR)
Enzyme-Linked Immunosorbent Assay
030204 cardiovascular system & hematology
Risk Assessment
Receptors
Urokinase Plasminogen Activator
law.invention
Sepsis
03 medical and health sciences
0302 clinical medicine
Asian People
Risk Factors
law
Internal medicine
Humans
Medicine
Prospective Studies
030212 general & internal medicine
Intensive care medicine
Prospective cohort study
Risk stratification
APACHE
Aged
Aged
80 and over
Receiver operating characteristic
APACHE II
business.industry
Proportional hazards model
Middle Aged
Prognosis
medicine.disease
Intensive care unit
Intensive Care Units
Anesthesiology and Pain Medicine
SuPAR
Cohort
Regression Analysis
Female
business
Research Article
Zdroj: BMC Anesthesiology
ISSN: 1471-2253
DOI: 10.1186/s12871-016-0212-3
Popis: Background Timely risk stratification is the key strategy to improve prognosis of patients with sepsis. Previous study has proposed to develop a powerful risk assessment rule by the combination of Acute Physiology and Chronic Health Evaluation II (APACHE II) score and plasma soluble urokinase plasminogen activator receptor (suPAR). That reaffirmation of suPAR as a prognostic marker in Chinese patients with severe sepsis is the aim of the study. Methods A total of 137 consecutive Chinese patients with sepsis were enrolled in a prospective study cohort. Demographic and clinical characteristics, conventional risk factors and important laboratory data were prospectively recorded. Sequential plasma suPAR concentrations were measured by an enzymeimmunoabsorbent assay on days 1, 3, and 7 after admission to the intensive care unit (ICU). Receiver operating characteristic (ROC) curves and Cox regression analysis were used to examine the performance of suPAR in developing a rule for risk stratification. Results The results showed that plasma suPAR concentrations remained relatively stable within survivors and non-survivors during the first week of disease course. Regression analysis indicated that APACHE II ≥15 and suPAR ≥10.82 ng/mL were independently associated with unfavorable outcome. With the above cutoffs of APACHE II and suPAR, strata of disease severity were determined. The mortality of each stratum differed significantly from the others. Conclusions Combination of APACHE II score and suPAR may supply the powerful prognostic utility for the mortality of sepsis.
Databáze: OpenAIRE
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