Document Detail

Soluble urokinase-type plasminogen activator receptor (suPAR) in patients with suspected infection in the emergency room: a prospective cohort study.
MedLine Citation:
PMID:  22755554     Owner:  NLM     Status:  Publisher    
OBJECTIVES: The soluble form of urokinase-type plasminogen activator (suPAR) was evaluated as an early prognostic marker of sepsis in patients with suspected infection. DESIGN: A single-centre prospective cohort study. METHODS: The cohort comprised 539 patients in the emergency department with suspected infection: 59 without systemic inflammatory response syndrome (SIRS) and without bacterial infection (group 1), 68 with bacterial infection without SIRS (group 2), 54 with SIRS without bacterial infection (group 3), 309 with sepsis (SIRS and bacterial infection) without organ failure (group 4) and 49 with severe sepsis (SIRS, bacterial infection and organ failure) (group 5). suPAR was measured on admission using a commercial solid-phase enzyme-linked immunosorbent assay. RESULTS: The median suPAR concentrations in groups 1-5 were 4.7, 5.0, 4.4, 4.8 and 7.9 ng/mL, respectively (P<0.001). The levels were significantly higher in non-survivors compared to survivors (8.3 vs. 4.9 ng/mL, P<0.001) and in patients with severe sepsis (group 5) compared to those in the other groups (7.9 vs. 4.8 ng/mL, P<0.001). Area under the receiver operating characteristics curve (AUC(ROC) ) for the prediction of case fatality was 0.79 (95% confidence interval [CI] 0.72-0.86, P<0.0001), and 0.75 for severe sepsis (95% CI 0.68-0.81, P<0.0001). At a cut-off level of 6.4 ng/mL, suPAR had 76% sensitivity and 69% specificity for fatal disease; at a cut-off level of 6.6 ng/mL the sensitivity and specificity for severe sepsis were 67% and 72%, respectively. In multivariate models, high suPAR remained an independent predictor of case fatality and severe sepsis after adjusting for potential confounders. CONCLUSIONS: A high suPAR level predicts case fatality and severe sepsis in patients with suspected infection. © 2012 The Association for the Publication of the Journal of Internal Medicine.
Raija Uusitalo-Seppälä; Reetta Huttunen; Maija Tarkka; Janne Aittoniemi; Pertti Koskinen; Aila Leino; Tero Vahlberg; Esa M Rintala
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-3
Journal Detail:
Title:  Journal of internal medicine     Volume:  -     ISSN:  1365-2796     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904841     Medline TA:  J Intern Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Association for the Publication of the Journal of Internal Medicine.
Department of Infectious Diseases, Satakunta Central Hospital, Pori, Finland.
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