Soluble urokinase–type plasminogen activator receptor as a prognostic biomarker in critically ill patients

Donadello, Katia; Scolletta, Sabino; Taccone, Fabio Silvio; Covajes, Cecilia; Santonocito, Cristina; Cortés, Diego Orbegozo; Gražulytė, Daiva; Gottin, Leonardo; Vincent, Jean‐Louis

doi:10.1016/j.jcrc.2013.08.005

Cited by 79 publications

(78 citation statements)

References 32 publications

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“…Despite this, after adjusting for preexisting renal failure, suPAR levels that exceed the cut-off value maintained their independent value in predicting sepsis bacteremia. Significantly higher values of suPAR in patients with impaired renal function were recorded as results in the previously cited study of Hoenigl, that took place on a group of septic patients (p=0.0017) but in this group the significant difference was not maintained in the bacteremia subgroup (30,40). Previously, other authors reported that the serum levels of this BM are related to renal failure, independent on the presence or absence of sepsis in critical patients admitted to the ICU (27,30).…”

Section: Discussionmentioning

confidence: 52%

“…To confirm, suPAR values were determined on a group of 13 healthy adults (members of our medical staff), the median on this lot being 1.67 ng/mL (IQR 0.42-5.05 ng/mL), those being similar to the one identified by Donadello on a similar control group (2.5 ng/mL, IQR 2.1-3 ng/ mL) (30). Although overall the diagnosing value of suPAR in sepsis is admittedly low, AUC to discriminate between septic and non-septic ICU patients being poor, this study confirms elevated levels of this BM in septic patients (26)(27)(28).…”

Section: Discussionmentioning

confidence: 86%

“…In another study in which the presence of SIRS and not infection was the inclusion criteria, AUC values for suPAR and PCT were very close and superior for the latter: 0.726 (95% CI 0.638-0.814) and respectively, 0.744 (95% CI 0.650-0.838), these two BMs continuing to be predictive bacteremia factors in SIRS patients, including after multivariable logistic regression analysis (40). Recently, Donatello confirmed the predictive capacity of suPAR for bacteremia in a group of patients admitted for surgical sepsis or a medical cause in an ICU and Wittenhagen reported that serum levels of suPAR were greatly increased in pneumococcal bacteremia (5.5 ng/mL IQR 2.4-4.0 ng/mL vs 2.6 ng/mL IQR 1.5-4 ng/mL) (30,42). Differences of suPAR values in Gram-positive germs versus Gram-negative germs bacteremia were not recorded, result that is different from the conclusion of a larger study done on 132 patients with SIRS in which the values were significantly higher in Gram-negative bacteremia but the result is concordant with the results reported by Huttunen (21,40).…”

Section: Discussionmentioning

confidence: 94%

“…The capacity of suPAR to discriminate between bacterial infection and other causes of sepsis seems to be also limited (27)(28)(29). Several studies support its superior value as a prognostic BM in sepsis (28,30,31).…”

Section: Introductionmentioning

confidence: 99%

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Soluble urokinase-type plasminogen activator receptor (suPAR) – a possible biomarker for bacteremia in sepsis / Forma solubilă a receptorului pentru activatorul de plasminogen de tip urokinază (suPAR) – un biomarker posibil pentru bacteriemie în sepsis

Georgescu¹,

Szederjesi²,

Voidăzan³

et al. 2015

Romanian Review of Laboratory Medicine

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Background. Validating new sepsis biomarkers can contribute to early diagnosis and initiation of therapy. The aim of this study is to evaluate the sepsis predictive capacity of soluble urokinase plasminogen receptor (suPAR) and its role in evaluating the prognosis of bloodstream infections. Material and method. We conducted a prospective pilot study on 49 systemic inflammatory response syndrome (SIRS) patients admitted to the intensive care unit (ICU), that were divided, on the basis of bacteremia in group A (SIRS with bacteremia, n=14) and group B (SIRS without bacteremia, n=35). Hemoculture and blood samples were drawn on the first day to determine suPAR, C-reactive protein (CRP) and procalcitonin (PCT). We set to identify significant cut-off values in estimating bacteremia and mortality in septic patients. Results. In group A, suPAR values were 14.3 ng/mL (range 10-45.5 ng/mL) and in group B, 9.85 ng/mL (range 3.4-48 ng/mL) p=0.008. Area under the curve (AUC) for suPAR was 0.745 (95% CI: 0.600-0.859), for CRP 0.613 (95% CI: 0.522-0.799) and for PCT 0.718 (95% CI: 0.477-0.769). Cut-off value for suPAR in bacteremia prediction was 9.885 ng/mL, with 100% sensibility and 51.43% specificity. Mortality in group A was 85.7% (12/14) and in group B 74.3% (26/39), p>0.05. Area under the curve (AUC) for suPAR was 0.750 (95% CI: 0.455-0.936), for CRP 0.613 (95% CI: 0.413-0.913) and for PCT 0.618 (95% CI: 0.373-0.888). Cut-off value of suPAR in predicting mortality was 11.5 ng/mL, with 66.67% sensibility and 100% specificity. Conclusions. In our study suPAR had a predictive capacity for bacteremia and seems to be an independent factor for mortality prognosis in septic patients.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Soluble urokinase-type plasminogen activator receptor (suPAR) – a possible biomarker for bacteremia in sepsis / Forma solubilă a receptorului pentru activatorul de plasminogen de tip urokinază (suPAR) – un biomarker posibil pentru bacteriemie în sepsis

Georgescu¹,

Szederjesi²,

Voidăzan³

et al. 2015

Romanian Review of Laboratory Medicine

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“…Recent studies showed that high levels of suPAR are able to predict mortality in patients with diseases that are associated with inflammatory response. Additionally, the time course of suPAR seems to correlate with disease severity and the degree of organ dysfunction [79,80] . suPAR has gained growing interest because of its role as a predictor of disease severity in patients with bacteraemia [81] .…”

Section: Soluble Urokinase-type Plasminogen Activator Receptormentioning

confidence: 99%

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Kojic

Siegler

Uhle

et al. 2015

WJEM

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Beside many efforts to improve outcome, sepsis is still one of the most frequent causes of death in critically ill patients. It is the most common condition with high mortality in intensive care units. The complexity of the septic syndrome comprises immunological aspects -i.e. , sepsis induced immunosuppression -but is not restricted to this fact in modern concepts. So far, exact mechanisms and variables determining outcome and mortality stay unclear. Since there is no typical risk profile, early diagnosis and risk stratification remain difficult, which hinders rapid and effective treatment initiation. Due to the heterogeneous nature of sepsis, potential therapy options should be adapted to the individual. Biomarkers like C-reactive protein and procalcitonin are routinely used as complementary tools in clinical decision-making. Beyond the acute phase proteins, a wide bunch of promising substances and non-laboratory tools with potential diagnostic and prognostic value is under intensive investigation. So far, clinical decision just based on biomarker assessment is not yet feasible. However, biomarkers should be considered as a complementary approach. Core tip: Sepsis is a complex continuum of disturbed systems. Despite the presence of clinical consensus criteria, the early diagnosis especially in the perioperative setting is challenging. A magnitude of potential new biomarkers is tested for this purpose, but evidence is mounting that due to the complex nature of the syndrome, biomarkers are rather complementary tools for clinical decision making than "magic bullets". Moreover, biomarkers are also evaluated for therapy guidance, linking diagnostic results to an individual therapeutic regime. This review summarizes the developments in the biomarker field, aiming to provide an overview about current targets and their limitations.

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Biomarkers in Inflammation

Kortgen

Bauer

2017

Inflammation - From Molecular and Cellular Mechanisms to the Clinic

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Soluble urokinase–type plasminogen activator receptor as a prognostic biomarker in critically ill patients

Cited by 79 publications

References 32 publications

Soluble urokinase-type plasminogen activator receptor (suPAR) – a possible biomarker for bacteremia in sepsis / Forma solubilă a receptorului pentru activatorul de plasminogen de tip urokinază (suPAR) – un biomarker posibil pentru bacteriemie în sepsis

Soluble urokinase-type plasminogen activator receptor (suPAR) – a possible biomarker for bacteremia in sepsis / Forma solubilă a receptorului pentru activatorul de plasminogen de tip urokinază (suPAR) – un biomarker posibil pentru bacteriemie în sepsis

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Biomarkers in Inflammation

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