Prognostic and Pathogenetic Value of Combining Clinical and Biochemical Indices in Patients With Acute Lung Injury

Ware, Lorraine B.; Koyama, Tatsuki; Billheimer, Dean; Wu, William; Bernard, Gordon R.; Thompson, B. Taylor; Brower, Roy G.; Standiford, Theodore J.; Martin, Thomas R.; Matthay, Michael A.

doi:10.1378/chest.09-1484

Cited by 267 publications

(269 citation statements)

References 34 publications

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“…A combination of both the clinical predictors and the eight biomarkers had an area under the curve of 0.85, significantly greater than the clinical predictors alone. The best performing biomarkers were IL-8 and SP-D, supporting the concept that acute inflammation and alveolar epithelial injury are important pathogenetic pathways in lung injury (15).…”

Section: Pathogenesis Of Ali In Human Studiessupporting

confidence: 55%

Update on Acute Lung Injury and Critical Care Medicine 2009

Matthay¹,

Idell²

2010

Am J Respir Crit Care Med

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Section: Pathogenesis Of Ali In Human Studiessupporting

confidence: 55%

Update on Acute Lung Injury and Critical Care Medicine 2009

Matthay¹,

Idell²

2010

Am J Respir Crit Care Med

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“…Upscaling from one stage of the Berlin classification to another would mean a 1.14-fold mortality increase OR odds ratio, suPAR soluble urokinase plasminogen activator receptor, APACHE IV Acute Physiology and Chronic Health Evaluation IV, SOFA Sequential Organ Failure Assessment score, OI oxygenation index biological markers or clinical disease severity scores to improve mortality prediction. Combining biochemical and clinical parameters has previously improved outcome prediction in patients with lung injury [26]. There was no increase in the ROC-AUC when combining suPAR with the APACHE IV score, SOFA score, oxygenation index, or Berlin classification.…”

Section: Discussionmentioning

confidence: 93%

Plasma suPAR as a prognostic biological marker for ICU mortality in ARDS patients

et al. 2015

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Purpose: We investigated the prognostic value of plasma soluble urokinase plasminogen activator receptor (suPAR) on day 1 in patients with the acute respiratory distress syndrome (ARDS) for intensive care unit (ICU) mortality and compared it with established disease severity scores on day 1. Methods: suPAR was determined batchwise in plasma obtained within 24 h after admission. Results: 632 ARDS patients were included. Significantly (P = 0.02) higher median levels of suPAR were found with increasing severity of ARDS: 5.9 ng/ml [IQR 3.1-12.8] in mild ARDS (n = 82), 8.4 ng/ml .0] in moderate ARDS (n = 333), and 9.0 ng/ml .0] in severe ARDS (n = 217). Non-survivors had higher median levels of suPAR [12.5 ng/ml (IQR 5.1-19.5) vs. 7.4 ng/ml (3.9-13.6), P \ 0.001]. The area under the receiver operator characteristic curve (ROC-AUC) for mortality of suPAR (0.62) was lower than the ROC-AUC of the APACHE IV score (0.72, P = 0.007), higher than that of the ARDS definition classification (0.53, P = 0.005), and did not differ from that of the SOFA score (0.68, P = 0.07) and the oxygenation index (OI) (0.58, P = 0.29). Plasma suPAR did not improve the discrimination of the established disease severity scores, but did improve net reclassification of the APACHE score (29 %), SOFA score (23 %), OI (38 %), and Berlin definition classification (39 %). Conclusion: As a single biological marker, the prognostic value for death of plasma suPAR in ARDS patients is low. Plasma suPAR, however, improves the net reclassification, suggesting a potential role for suPAR in ICU mortality prediction models.

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“…Understanding the early inflammatory changes triggered by different V T in healthy lungs, and the relationship of these changes with ventilatory parameters, may help identify injurious pulmonary insults and susceptible individuals. This knowledge may complement recently developed risk scores for predicting ARDS [15][16][17][18][19] or postoperative pulmonary complications 13,20 in their goal of early detection and prevention of lung inflammation.…”

Section: Introductionmentioning

confidence: 93%