scholarly journals Elevated Serum Tenascin-C Predicts Mortality in Critically Ill Patients With Multiple Organ Dysfunction

2021 ◽  
Vol 8 ◽  
Author(s):  
Yunyu Xu ◽  
Nanyang Li ◽  
Jiamin Gao ◽  
Da Shang ◽  
Min Zhang ◽  
...  
Keyword(s):  
Critically Ill ◽  
Organ Dysfunction ◽  
Critically Ill Patients ◽  
Elevated Serum ◽  
Multiple Organ ◽  
Apache Ii ◽  
Consecutive Series ◽  
Multiple Organ Dysfunction ◽  
Tenascin C ◽  
Saps Ii

Background: Multiple organ dysfunction is a complex and lethal clinical feature with heterogeneous causes and is usually characterized by tissue injury of multiple organs. Tenascin-C (TNC) is a matricellular protein that is rarely expressed in most of the adult tissues, but re-induced following injury. This study aimed to evaluate serum TNC in predicting mortality in critically ill patients with multiple organ dysfunction.Methods: Adult critically ill patients with at least two organs dysfunction and an increase of Sequential Organ Failure Assess (SOFA) score ≥ 2 points within 7 days were prospectively enrolled into two independent cohorts. The emergency (derivation) cohort was a consecutive series and the patients were from Emergency Department. The inpatient (validation) cohort was a convenience series and the patients were from medical wards. Their serum samples at the first 24 h after enrollment were collected and subjected to TNC measurement using ELISA. The association between serum TNC level and 28-day all-cause mortality was investigated, and then the predictive value of serum TNC was analyzed.Results: A total of 110 patients with a median age of 64 years (53, 73) were enrolled in the emergency cohort. Compared to the survivors, serum TNC in the non-survivors was significantly higher (467.7 vs. 197.5 ng/ml, p < 0.001). Multivariate logistic regression analysis revealed that the association between serum TNC and 28-day mortality was independent of sepsis or critical illness scores such as SOFA, Acute Physiology and Chronic Health Evaluation (APACHE II), and Simplified Acute Physiology Score (SAPS II), respectively (p < 0.001 for each). The area under receiver operating characteristic curve of serum TNC for predicting mortality was 0.803 (0.717–0.888) (p < 0.001), similar with SOFA 0.808 (0.725–0.891), APACHE II 0.762 (0.667–0.857), and SAPS II 0.779 (0.685–0.872). The optimal cut-off value of serum TNC was 298.2 ng/ml. Kaplan–Meier analysis showed that the survival of patients with serum TNC ≥ 300 ng/ml was significantly worse than that of patients with serum TNC < 300 ng/ml. This result was validated in the inpatient cohort. The sensitivity and specificity of serum TNC ≥ 300 ng/ml for predicting mortality were 74.3 and 74.7% in the emergency cohort, and 63.0 and 70.1% in the inpatient cohort, respectively.Conclusion: Serum TNC was associated with mortality in critically ill patients with multiple organ dysfunction, and would be used as a prognostic tool for predicting mortality in this population.

SOLUBLE FAS LEVELS CORRELATE WITH MULTIPLE ORGAN DYSFUNCTION SEVERITY, SURVIVAL AND NITRATE LEVELS, BUT NOT WITH CELLULAR APOPTOTIC MARKERS IN CRITICALLY ILL PATIENTS

Shock ◽  
2000 ◽  
Vol 14 (2) ◽  
pp. 107-112 ◽  
Author(s):  
Elizabeth D. E. Papathanassoglou ◽  
Jan A. Moynihan ◽  
Dianne L. Vermillion ◽  
Michael P. McDermott ◽  
Michael H. Ackerman
Keyword(s):  
Critically Ill ◽  
Organ Dysfunction ◽  
Critically Ill Patients ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Soluble Fas ◽  
Apoptotic Markers

Blood Interleukin-6 Levels Predict Multiple Organ Dysfunction in Critically Ill Patients

Shock ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Takashi Shimazui ◽  
Taka-Aki Nakada ◽  
Megumi Yazaki ◽  
Toshihiko Mayumi ◽  
Osamu Takasu ◽  
...  
Keyword(s):  
Critically Ill ◽  
Organ Dysfunction ◽  
Critically Ill Patients ◽  
Interleukin 6 ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction

scholarly journals Diagnostic Accuracy of Biomarkers for Early Multiple Organ Dysfunction in Critically Ill Patients: A Multicenter Prospective Observational Study

2020 ◽  
Author(s):  
Shigeto Ishikawa ◽  
Yuto Teshima ◽  
Hiroki Otsubo ◽  
Takashi Shimazui ◽  
Taka-aki Nakada ◽  
...  
Keyword(s):  
Emergency Department ◽  
Observational Study ◽  
Critically Ill ◽  
Organ Dysfunction ◽  
Critically Ill Patients ◽  
Characteristic Curve ◽  
Treatment Strategies ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Qsofa Score

Abstract BackgroundShock and organ damage occur in critically ill patients in the emergency department because of biological responses to invasion, and cytokines play an important role in their development. It is important to predict early multiple organ dysfunction (MOD) because it is useful in predicting patient outcomes and selecting treatment strategies. This study examined the accuracy of biomarkers, including interleukin (IL)-6, in predicting early MOD in critically ill patients compared with that of quick sequential organ failure assessment (qSOFA).MethodsThis observational study was conducted at five universities from 2016 to 2018. Data of adult patients with systemic inflammatory response syndrome who presented to the emergency department or were admitted to the intensive care unit were prospectively evaluated. qSOFA score and each biomarker (IL-6, IL-8, IL-10, tumor necrosis factor-α, C-reactive protein, and procalcitonin [PCT]) level were assessed on Days 0, 1, and 2. The primary outcome was set as MOD on Day 2, and the area under the receiver operating characteristic curve (AUROC) was analyzed to evaluate qSOFA scores and biomarker levels.ResultsOf 199 patients, 38 were excluded and 161 were included. Patients with MOD on Day 2 had significantly higher qSOFA, SOFA, and Acute Physiology and Chronic Health Evaluation II scores and a trend toward worse prognosis, including mortality. The AUROC for qSOFA score (Day 0) that predicted MOD (Day 2) was 0.728 (95% confidence interval [CI]: 0.651–0.794). IL-6 (Day 1) showed the highest AUC among all biomarkers (0.790 [95% CI: 0.711–852]). The combination of qSOFA (Day 0) and IL-6 (Day 1) showed improved prediction accuracy (0.859 [95% CI: 0.792–0.907]). The combination model using qSOFA (Day 0) and IL-6 (Day 1) also showed a higher AUROC (0.889 [95% CI: 0.828–0.929]).ConclusionsThe addition of serum IL-6 level to qSOFA scores improved the accuracy of early MOD prediction.

scholarly journals Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shigeto Ishikawa ◽  
Yuto Teshima ◽  
Hiroki Otsubo ◽  
Takashi Shimazui ◽  
Taka-aki Nakada ◽  
...  
Keyword(s):  
Emergency Department ◽  
Critically Ill ◽  
Organ Dysfunction ◽  
Critically Ill Patients ◽  
Treatment Strategies ◽  
Area Under The Curve ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Combination Model ◽  
Qsofa Score

Abstract Background Shock and organ damage occur in critically ill patients in the emergency department because of biological responses to invasion, and cytokines play an important role in their development. It is important to predict early multiple organ dysfunction (MOD) because it is useful in predicting patient outcomes and selecting treatment strategies. This study examined the accuracy of biomarkers, including interleukin (IL)-6, in predicting early MOD in critically ill patients compared with that of quick sequential organ failure assessment (qSOFA). Methods This was a multicenter observational sub-study. Five universities from 2016 to 2018. Data of adult patients with systemic inflammatory response syndrome who presented to the emergency department or were admitted to the intensive care unit were prospectively evaluated. qSOFA score and each biomarker (IL-6, IL-8, IL-10, tumor necrosis factor-α, C-reactive protein, and procalcitonin [PCT]) level were assessed on Days 0, 1, and 2. The primary outcome was set as MOD on Day 2, and the area under the curve (AUC) was analyzed to evaluate qSOFA scores and biomarker levels. Results Of 199 patients, 38 were excluded and 161 were included. Patients with MOD on Day 2 had significantly higher qSOFA, SOFA, and Acute Physiology and Chronic Health Evaluation II scores and a trend toward worse prognosis, including mortality. The AUC for qSOFA score (Day 0) that predicted MOD (Day 2) was 0.728 (95% confidence interval [CI]: 0.651–0.794). IL-6 (Day 1) showed the highest AUC among all biomarkers (0.790 [95% CI: 0.711–852]). The combination of qSOFA (Day 0) and IL-6 (Day 1) showed improved prediction accuracy (0.842 [95% CI: 0.771–0.893]). The combination model using qSOFA (Day 1) and IL-6 (Day 1) also showed a higher AUC (0.868 [95% CI: 0.799–0.915]). The combination model of IL-8 and PCT also showed a significant improvement in AUC. Conclusions The addition of IL-6, IL-8 and PCT to qSOFA scores improved the accuracy of early MOD prediction.

Sign in / Sign up

Export Citation Format

Share Document