Is Pyroglutamic Acid a Prognostic Factor Among Patients with Suspected Infection? A Prospective Cohort Study
| Autor: | Yarden Perach Ovadia, Itai Gueta, Avi Epsztein, Yehoshua N Schacham, Ronen Loebstein, Noa Markovits |
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| Rok vydání: | 2020 |
| Předmět: |
Data Analysis
Male Risk medicine.medical_specialty Multivariate analysis lcsh:Medicine Urine 030204 cardiovascular system & hematology Predictive markers Gastroenterology Article Sepsis Prognostic markers 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Heart rate medicine Humans Hospital Mortality Prospective Studies 030212 general & internal medicine lcsh:Science Prospective cohort study Aged Aged 80 and over Analysis of Variance Creatinine Univariate analysis Multidisciplinary business.industry lcsh:R Emergency department Prognosis medicine.disease Pyrrolidonecarboxylic Acid chemistry Infectious diseases lcsh:Q Female business Negative Results Biomarkers |
| Zdroj: | Scientific Reports Scientific Reports, Vol 10, Iss 1, Pp 1-6 (2020) |
| ISSN: | 2045-2322 |
| DOI: | 10.1038/s41598-020-66941-7 |
| Popis: | Pyroglutamic acid (PGA) is a compound that accumulates during oxidative stress and hence, elevated levels may be associated with poor prognosis in patients with infection or sepsis. To examine this hypothesis, patients presenting with acute infection were recruited in the emergency department and prospectively followed for 30 days. Sport urine samples were quantified for PGA. Outcomes were mortality and composite outcome of death or organ failure. Thirty two (32%) patients had qSOFA≥2. Median urine PGA was 22.9 (IQR 17.64, 33.53) µmol/mmol creatinine. Four patients demonstrated PGA values ≥ 63 µmol/mmol creatinine. Univariate analysis showed that PGA concentration ≥ 75th percentile (i.e. 33.53 µmol/mmol creatinine) was associated with higher rates of in-hospital mortality (p = 0.041) with similar trend for PGA ≥ 63 µmol/mmol creatinine (p = 0.04). However, multivariate analysis showed that PGA was not associated with worse outcomes, whereas heart rate was associated with both composite outcomes (HR 1.0, p = 0.008 and HR 1.02, p = 0.001 for composite outcome with 30 days and in-hospital mortality, respectively). Among low risk patients, high PGA levels were consistently associated with worse outcomes. In conclusion, urine PGA concentration was not associated with worse outcomes among septic patients. Nevertheless, future studies should evaluate this association in larger cohorts. |
| Databáze: | OpenAIRE |
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