Prognostic value of international normalized ratio to albumin ratio among critically ill patients with cirrhosis

et al. 2020

Preprint

Background: The distribution of biomarkers over time is considered an indicator of disease formation and helps in early detection of disease, thus reducing the disease-related mortality. The ability of biomarkers to predict outcomes has been evaluated using conventional cross-sectional methods; therefore, we investigated the prognostic potential of longitudinal biomarkers over time.Methods: The patients aged > 18 y who were admitted within 24 h of the burn incident in the burn intensive care unit were enrolled. Longitudinal biomarkers, such as WBC, platelet count, lactate, creatinine, TB, and PT were retrieved from a clinical database warehouse. Time-dependent ROC curves using a cumulative/dynamic and incident/dynamic approach were employed to evaluate time-varying prognostic performance.Results: Total 2259 patients were included in this retrospective study and divided into the survival group and non-survival group. With AUC using the ID approach, platelets showed the highest c-index with 0.930 (0.919 ~ 0.941) as well as the highest during all time points. PT and creatinine show over 8 c-index with 0.862 (0.843 ~ 0.881) and 0.828 (0.809 ~ 0.848), respectively.Conclusions: The platelet count was the best prognostic marker. PT and creatinine also showed good overall diagnostic ability. Lactate is known as a strong predictor; however, it showed relatively poorer prognostic performance in burns.

Section: Discussionmentioning

confidence: 99%

Time-Varying Discrimination Accuracy of Longitudinal Biomarkers for the Prediction of Mortality Compared to Assessment at Fixed Time Point in Severe Burns Patients

et al. 2020

Preprint

“…This is probably because AKI is one of the most common complications in burn patients. PT showed a high c-index of 0.862 because PT was reported as a predictor in many diseases, such as liver disease, cardiac disease, and trauma (17)(18)(19). PT is reported to be an early predictor of hepatic dysfunctions (20).…”

Section: Discussionmentioning

confidence: 99%

Time-varying Discrimination Accuracy of Longitudinal Biomarkers for the Prediction of Mortality Compared to Assessment at Fixed Time Point in Severe Burns Patients

et al. 2020

Preprint

Background: The distribution of biomarkers over time is considered as an indicator of disease progression and helps in the early detection of disease, thereby reducing disease-related mortality. The ability of biomarkers to predict outcomes has been evaluated using conventional cross-sectional methods. In this study, we investigated the prognostic performance of longitudinal biomarkers over time.Methods: Patients aged >18 years who were admitted to the burn intensive care unit within 24 h of a burn incident were enrolled. Information regarding longitudinal biomarkers, such as white blood cell; platelet count; lactate, creatinine, and total bilirubin levels; and prothrombin time (PT), were retrieved from a clinical database warehouse. Time-dependent receiver operating characteristic curves using cumulative/dynamic and incident/dynamic (ID) approaches were used to evaluate time-varying prognostic performance.Results: In total, 2259 patients were included in this retrospective study and divided into survival and non-survival groups. By determining the area under the curve using the ID approach, platelets showed the highest c-index [0.930 (0.919–0.941)] across all time points. On the other hand, the c-index of PT and creatinine levels was 0.862 (0.843–0.881) and 0.828 (0.809–0.848), respectively.Conclusions: Platelet count is the best prognostic marker. PT and creatinine levels also show good overall diagnostic ability. Although lactate is a strong predictor, it shows relatively poor prognostic performance in burns patients.

“…This is probably because AKI is one of the most common complications in burn patients. PT also showed high discrimination, with a cindex of 0.862, and has been reported to be a predictor in many diseases, such as liver disease, cardiac disease, and trauma (20)(21)(22). PT is reported as an early predictor of hepatic dysfunctions (23).…”

Section: Discussionmentioning

confidence: 99%

Time-varying discrimination accuracy of longitudinal biomarkers for the prediction of mortality compared to assessment at fixed time point in severe burns patients

et al. 2020

Preprint

Background: The progression of biomarkers over time is considered an indicator of disease progression and helps in the early detection of disease, thereby reducing disease-related mortality. Their ability to predict outcomes has been evaluated using conventional cross-sectional methods. This study investigated the prognostic performance of biomarkers over time.Methods: Patients aged >18 years admitted to the burn intensive care unit within 24 h of a burn incident were enrolled. Information regarding longitudinal biomarkers, including white blood cells; platelet count; lactate, creatinine, and total bilirubin levels; and prothrombin time (PT), were retrieved from a clinical database. Time-dependent receiver operating characteristic curves using cumulative/dynamic and incident/dynamic (ID) approaches were used to evaluate prognostic performance.Results: Overall, 2259 patients were included and divided into survival and non-survival groups. By determining the area under the curve using the ID approach, platelets showed the highest c-index [0.930 (0.919–0.941)] across all time points. Conversely, the c-index of PT and creatinine levels were 0.862 (0.843–0.881) and 0.828 (0.809–0.848), respectively.Conclusions: Platelet count was the best prognostic marker, followed by PT. Total bilirubin and creatinine levels also showed good prognostic ability. Although lactate was a strong predictor, it showed relatively poor prognostic performance in burns patients.