Using soluble urokinase plasminogen activator receptor to stratify patients for medication review in the emergency department

Bengaard, Anne Kathrine; Iversen, Esben; Kallemose, Thomas; Juul‐Larsen, Helle Gybel; Rasmussen, Line Jee Hartmann; Dalhoff, Kim; Andersen, Ove; Eugen‐Olsen, Jesper; Houlind, Morten Baltzer

doi:10.1111/bcp.14982

Cited by 5 publications

(8 citation statements)

References 66 publications

(148 reference statements)

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“…Out of 16 included studies, 5 studies [ 27 , 30 , 31 , 35 , 36 ] provided data on the outcome of 90-day mortality. There were significantly higher odds of risks of 90-day mortality in patients with high suPAR levels as compared to those with low suPAR levels (RR = 11.23; 95% CI = 4.48–28.12; P < .00001; I 2 = 92%) as shown in Supplementary Figure S2, http://links.lww.com/MD/K598 .…”

Section: Resultsmentioning

confidence: 99%

“…There were significantly higher odds of risks of 90-day mortality in patients with high suPAR levels as compared to those with low suPAR levels (RR = 11.23; 95% CI = 4.48–28.12; P < .00001; I 2 = 92%) as shown in Supplementary Figure S2, http://links.lww.com/MD/K598 . Sensitivity analysis was performed by removing 2 studies, [ 30 , 31 ] this yielded a change in risk (RR = 5.76; 95% CI = 3.35–9.91; P < .00001) as well as mild heterogeneity between the studies (I 2 = 36%; P = .21). (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Study and patients' baseline characteristics have been summarized in Tables 1 and 2 respectively. Out of all 13 included studies, 12 are observational studies [19,21,23,[27][28][29][30][31][32][33]35,36] and 1 is post hoc analysis of a multicenter study. [34] Included studies were published between July 2012 till June 2022.…”

Section: Study Characteristics and Patients' Baseline Characteristicsmentioning

confidence: 99%

“…After a full-text assessment of 43 articles for their eligibility, 30 articles were excluded which didn't meet the inclusion criteria. As a result, 13 studies [19,21,23,[27][28][29][30][31][32][33][34][35][36] were finalized to be included in this meta-analysis. A summary of the literature search is presented in Figure 1.…”

Section: Literature Searchmentioning

confidence: 99%

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Role of soluble urokinase type plasminogen activator receptor (suPAR) in predicting mortality, readmission, length of stay and discharge in emergency patients: A systematic review and meta analysis

Rehan,

Hussain,

Ali

et al. 2023

Medicine

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Background: Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker that is used to predict mortality, readmission, early discharge, and LOS, thus, serves as a useful tool for ED physicians. Our study aims to analyze the efficacy of suPAR in predicting these prognostic markers in ED. Methods: We performed a comprehensive search on 6 databases from the inception to 30th November 2022, to select the following eligibility criteria; a) observation or triage trial studies investigating the role of suPAR levels in predicting: 30 day and 90-day mortality, 30-day readmission, early discharge (within 24hr), and LOS in patients coming to AMU. Results: A total of 13 studies were included, with a population size of 35,178, of which 52.9% were female with a mean age of 62.93 years. Increased risk of 30-day mortality (RR = 10.52; 95% CI = 4.82–22.95; I2 = 38%; P < .00001), and risk of 90-day mortality (RR = 5.76; 95% CI = 3.35–9.91; I2 = 36%; P < .00001) was observed in high suPAR patients. However, a slightly increased risk was observed for 30-day readmission (RR = 1.50; 95% CI = 1.16–1.94; I2 = 54%; P = .002). More people were discharged within 24hr in the low suPAR level group compared to high suPAR group (RR = 0.46; 95% CI = 0.40–0.53; I2 = 41%; P < .00001). LOS was thrice as long in high suPAR level patients than in patients with low suPAR (WMD = 3.20; 95% CI = 1.84–4.56; I2 = 99%; P < .00001). Conclusion: suPAR is proven to be a significant marker in predicting 30-day and 90-day mortality in ED patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Characteristics and Patients' Baseline Characteristicsmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

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Role of soluble urokinase type plasminogen activator receptor (suPAR) in predicting mortality, readmission, length of stay and discharge in emergency patients: A systematic review and meta analysis

Rehan,

Hussain,

Ali

et al. 2023

Medicine

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“…Most research on biomarkers and polypharmacy have focussed on pharmacogenomic markers, such as genetic variants that affect pharmacokinetics. In this volume, Bengaard et al 6 outline a novel cohort study to investigate the relationship between polypharmacy, health outcomes and soluble urokinase plasminogen activator receptor (suPAR), a nonspecific biomarker that reflects immune activity. SuPAR is a marker for increasing age, impaired cardiac, renal and hepatic function, exacerbations of inflammatory conditions such as autoimmune connective tissue disorders and chronic obstructive pulmonary disease, and lifestyle factors such as smoking and obesity 7,8 .…”

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confidence: 99%

Stratifying patients for polypharmacy interventions: The case for a new biomarker?

Threapleton

Harris

Baker

2021

Brit J Clinical Pharma

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Soluble urokinase plasminogen activator receptor and decline in kidney function among patients without kidney disease

Iversen

Kallemose

Hornum

et al. 2022

Clinical Kidney Journal

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Background Hospitalized patients are at elevated risk of developing kidney disease after discharge, often despite the absence of any clinical indicators during hospitalization. Soluble urokinase plasminogen activator receptor (suPAR) is a marker of systemic chronic inflammation that can be measured from routine blood samples. We determined whether elevated suPAR during hospitalization is associated with decline in estimated glomerular filtration rate (eGFR) after discharge. Methods This was a retrospective longitudinal cohort study of patients without detectable kidney disease presenting to the emergency department on two separate occasions during a 3-year period. Association between suPAR and decline in eGFR was assessed by linear mixed models for repeated measures adjusting for age, sex, C-reactive protein, sodium, diabetes, hypertension, and cardiovascular disease. Results In total, 5,124 patients (median age 65.9 years, 51.0% female) were included. Median suPAR was 2.9 ng/mL, median time to readmission was 144 days, and expected rate of eGFR decline over this period was 5.1 mL/min/1.73m2 per year. Adjusting for other risk factors, patients with suPAR <3, 3–6, or ≥6 ng/mL had an expected eGFR decline of 4.3, 5.2, or 9.0 mL/min/1.73m2 per year, respectively. Similarly, patients with suPAR in the lowest (<2.4 ng/mL), middle (2.4–3.6 ng/mL), or highest (≥3.6 ng/mL) tertile had an expected eGFR decline of 4.2, 4.6, or 6.5 mL/min/1.73m2 per year, respectively. In both cases, higher suPAR level was significantly and independently associated with higher rate of eGFR decline (P<0.001). Conclusions Higher suPAR level was associated with accelerated eGFR decline among patients presenting to the emergency department, suggesting that routine suPAR measurements may have utility for the early detection of kidney disease.

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Using soluble urokinase plasminogen activator receptor to stratify patients for medication review in the emergency department

Abstract: Aims: To investigate whether the association between levels of medication use (including polypharmacy and potentially inappropriate medications [PIMs]) and health outcomes such as readmission and mortality is dependent on baseline soluble urokinase plasminogen activator receptor (suPAR).

Cited by 5 publications

References 66 publications

Role of soluble urokinase type plasminogen activator receptor (suPAR) in predicting mortality, readmission, length of stay and discharge in emergency patients: A systematic review and meta analysis

Role of soluble urokinase type plasminogen activator receptor (suPAR) in predicting mortality, readmission, length of stay and discharge in emergency patients: A systematic review and meta analysis

Stratifying patients for polypharmacy interventions: The case for a new biomarker?

Soluble urokinase plasminogen activator receptor and decline in kidney function among patients without kidney disease

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