Role of tissue disorder markers in the evaluation of disease progress and outcome prediction: a prospective cohort study in non‐cardiac critically ill patients

Ye, Jing; Chen, Zi; Ting-song, Wang; Tong, Jinlu; Li, Xiaoguang; Jiang, Jie; Chen, Erzhen; Lu, Yiming

doi:10.1002/jcla.20397

Cited by 8 publications

(5 citation statements)

References 27 publications

(18 reference statements)

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“…In this four-year retrospective study, 56.5% of the critically ill patients showed increased myoglobin levels (≥150 μg/mL). Our results were similar to those of a previous study with 179 critically ill patients, which reported that 40.8% of the critically ill patients without ACS had elevated myoglobin level and 18 (10%) patients presented severe myoglobin elevation (≥1,000 μg/mL) on admission to the ICU ( 5 ). The previous study included critically ill patients without surgery, while in our study, two-thirds were postsurgical patients.…”

Section: Discussionsupporting

confidence: 91%

“…Since recently, myoglobin has been used in the prognostic assessment of critically ill and postoperative patients (3,4). A prospective study of critically ill patients without cardiac disease showed that elevated myoglobin level within 24 h of admission was a major risk factor for in-hospital death and 180-day death (5). In addition, myoglobin can be used to predict mortality and conversion to critical illness in severe and critically ill COVID-19 patients, with better efficacy than troponin (6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

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Dynamic increase in myoglobin level is associated with poor prognosis in critically ill patients: a retrospective cohort study

Liu,

Jiang,

Yuan

et al. 2024

Front. Med.

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BackgroundMyoglobin is an important biomarker for monitoring critically ill patients. However, the relationship between its dynamic changes and prognosis remains unclear.MethodsWe retrospectively enrolled 11,218 critically ill patients from a general and surgical intensive care unit (ICU) of a tertiary hospital between June 2016 and May 2020. Patients with acute cardiovascular events, cardiac and major vascular surgeries, and rhabdomyolysis were excluded. To investigate the early myoglobin distribution, the critically ill patients were stratified according to the highest myoglobin level within 48 h after ICU admission. Based on this, the critically ill patients with more than three measurements within 1 week after ICU admission were included, and latent class trajectory modeling was used to classify the patients. The characteristics and outcomes were compared among groups. Sensitivity analysis was performed to exclude patients who had died within 72 h after ICU admission. Restricted mean survival time regression model based on pseudo values was used to determine the 28-day relative changes in survival time among latent classes. The primary outcome was evaluated with comparison of in-hospital mortality among each Trajectory group, and the secondary outcome was 28-day mortality.ResultsOf 6,872 critically ill patients, 3,886 (56.5%) had an elevated myoglobin level (≥150 ng/mL) at admission to ICU, and the in-hospital mortality significantly increased when myoglobin level exceeded 1,000 μg/mL. In LCTM, 2,448 patients were unsupervisedly divided into four groups, including the steady group (n = 1,606, 65.6%), the gradually decreasing group (n = 523, 21.4%), the slowly rising group (n = 272, 11.1%), and the rapidly rising group (n = 47, 1.9%). The rapidly rising group had the largest proportion of sepsis (59.6%), the highest median Sequential Organ Failure Assessment (SOFA) score (10), and the highest in-hospital mortality (74.5%). Sensitivity analysis confirmed that 98.2% of the patients were classified into the same group as in the original model. Compared with the steady group, the rapidly rising group and the slowly rising group were significantly related to the reduction in 28-day survival time (β = −12.08; 95% CI −15.30 to −8.86; β = −4.25, 95% CI −5.54 to −2.97, respectively).ConclusionElevated myoglobin level is common in critically ill patients admitted to the ICU. Dynamic monitoring of myoglobin levels offers benefit for the prognosis assessment of critically ill patients.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Dynamic increase in myoglobin level is associated with poor prognosis in critically ill patients: a retrospective cohort study

Liu,

Jiang,

Yuan

et al. 2024

Front. Med.

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“…AST had a prediction role in the severity of disease and U.S grade. However, it has not been a reliable finding, because AST level changed in many conditions such as systemic disorder ( Tables 2 and 3 ) ( 28 , 30 ). Nevertheless, in several papers like Purnak T, Sogabe M and Lin YC, AST was a predictor of NAFLD severity and U.S significantly ( 26 , 27 , 29 ).…”

Section: Discussionmentioning

confidence: 99%

Correlation of Body Mass Index and Serum Parameters With Ultrasonographic Grade of Fatty Change in Non-alcoholic Fatty Liver Disease

Abangah

Yousefi

Asadollahi

et al. 2014

Iran Red Cres Med J

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Background:Non-alcoholic fatty liver disease (NAFLD) is a common liver disease in the western population and expanding disease in the world. Pathological changes in fatty liver are like alcohol liver damage, which can lead to end-stage liver disease. The prevalence of NAFLD in obese or overweight people is higher than general population, and it seems that people with high Body Mass Index (BMI) or abnormality in some laboratory tests are more susceptible for severe fatty liver and high grade of NAFLD in ultrasonography (U.S).Objectives:This study aimed to evaluate the correlation of BMI and laboratory tests with NAFLD in ultrasonography.Materials and Methods:During a multi-step process, we selected two-hundred and thirteen cases from four hundred and eighteen patients with NAFLD. Laboratory tests performed included: ALT, AST, FBS, Triglyceride and cholesterol levels, hepatitis B surface antigen, hepatitis C antibody, ceruloplasmin, serum iron, TIBC, transferrin saturation, ferritin, AMA, ANA, ANTI LKM1, serum protein electrophoresis, TSH, anti TTG (IgA). BMI and ultrasonography for 213 patients were performed, and then data was analyzed. These parameters and grades of ultrasonography were compared with the values obtained using one way ANOVA. An ordinal logistic regression model was used to estimate the probability of ultrasonography grade. The Statistical Package for the Social Science program (SPSS, version 16.0) was used for data analysis.Results:Two-hundred and thirteen cases including 140 male and 73 female, were studied. In general, 72.3% of patients were overweight and obese. Post-hoc tests showed that only BMI (P < 0.001) and TG (P < 0.011) among variables had statistically significant associations with ultrasonography grade (USG), and ordinal logistic regression model showed that BMI and AST were the best predictors.Discussion:Our results suggest that in patients with NAFLD, BMI and TG are most effective factors in severity of fatty liver disease and ultrasonography grade (USG). On the other hand, BMI as a predictor can be helpful. But, AST has not been a reliable finding, because it changes in many conditions.

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“…AST is an intracellular enzyme that is released into serum when cell death occurrs. It is not a specific marker for liver cell death and may be elevated in other tissue injuries (45). Therefore, it seems that ALT and AST concentrations alone are not sensitive enough for the diagnosis or evaluation of liver function in NAFLD especially in the early stage of disease.…”

Section: Laboratory Investigationsmentioning

confidence: 99%

Non-Alcoholic Fatty Liver Disease: Diagnosis and Evaluation of Disease Severity

Jamali

2013

Thrita J Med Sci

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Context: Considering the increasing prevalence of obesity and insulin resistance syndrome worldwide, non-alcoholic fatty liver disease (NAFLD) has become a major health concern. Early diagnosis and proper management might prevent disease progression. The aim of this article is to review the current knowledge on the diagnosis and evaluation of disease severity in NAFLD. Evidence Acquisition: After excluding causes of liver cell damage, the patients with persistent aminotransferase levels and well-defined criteria for fatty liver at ultrasonography are presumed to have NAFLD. When concomitant liver disease exists, the diagnosis of NAFLD is questionable without liver biopsy. Considering the limitations of diagnostic methods, selection of the best diagnostic approach has become a conflicting issue in NAFLD. Results: The review of literature showed that clinical findings, imaging studies, and laboratory investigations are commonly used for the diagnosis and the evaluation of disease severity in NAFLD. The results of non-invasive methods are sometimes inconclusive. The histological information is necessary for confirming the NAFLD diagnosis in this occasion. Meanwhile, invasiveness and possible complications make the liver biopsy an unacceptable method for most patients. It is not recommended routinely when the clinical and paraclinical findings are apparently in favor of NAFLD. Conclusions: In view of the limitations of the above-mentioned modalities, liver biopsy remains the gold standard method for documentation of diagnosis and estimation of disease severity in NAFLD.Considering the increasing prevalence of obesity and insulin resistance syndrome worldwide, non-alcoholic fatty liver disease (NAFLD) has become a major health concern. Early diagnosis and proper management might prevent disease progression. The aim of this article is to review the current knowledge on the diagnosis and evaluation of disease severity in NAFLD.

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Role of tissue disorder markers in the evaluation of disease progress and outcome prediction: a prospective cohort study in non‐cardiac critically ill patients

Abstract: All the six tissue disorder markers are predictors of disease severity, organ failure, and outcome in non-cardiac critically illness. Among them, Mb plays a pivotable role. The combined use of Mb and APACHE-II suggest an effective method to determine the outcome of critical ill syndrome.

Cited by 8 publications

References 27 publications

Dynamic increase in myoglobin level is associated with poor prognosis in critically ill patients: a retrospective cohort study

Dynamic increase in myoglobin level is associated with poor prognosis in critically ill patients: a retrospective cohort study

Correlation of Body Mass Index and Serum Parameters With Ultrasonographic Grade of Fatty Change in Non-alcoholic Fatty Liver Disease

Non-Alcoholic Fatty Liver Disease: Diagnosis and Evaluation of Disease Severity

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