Interleukin 6, galectin 3, growth differentiation factor 15, and soluble ST2 for mortality prediction in critically ill patients
Interleukin 6, galectin 3, growth differentiation factor 15, and soluble ST2 for mortality prediction in critically ill patients
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DOI：
10.1016/j.jcrc.2016.03.020
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发表时间：
2016-08-01
影响因子：
3.7
通讯作者：
Mueller, Thomas
中科院分区：
文献类型：
--
作者：
Dieplinger, Benjamin;Egger, Margot;Mueller, Thomas
目的：本研究的目的是比较白细胞介素6（IL-6），半乳糖凝集素3，生长分化因子15（GDF-15），可溶性ST 2（sST 2）在危重病patients.Methods：在一个为期1年的研究期间，我们招募了530名连续患者入院的医疗重症监护病房的三级医院的预后价值。我们研究了炎症，肾脏和心脏生物标志物的组合预测90天的全因mortals.Results：在随访期间，118例患者死亡（22%）。在单变量分析中，基线时增加的IL-6、半乳糖凝集素3、GDF-15和sST 2血浆浓度是强预后标志物。然而，在多变量模型中，只有IL-6和sST 2仍然是独立的生物标志物，为常规使用的简化急性生理评分（SAPS）II增加了额外的预后信息。使用简单的多标记方法，SAPS II、IL-6和sST 2升高（即SAPS II >35、IL-6 >32.3 pg/mL和sST 2>103 ng/mL）的患者预后最差。结论：在这个异质性的危重患者组中，只有SAPS II、IL-6和sST 2仍然是90天全因死亡率的独立和相加的特异性标记。SAPS II与2种互补生物标志物的组合可能为危重患者的风险分层提供有价值的工具。(C)2016作者爱思唯尔公司出版
Purpose: The aim of this study was to compare the prognostic value of interleukin 6 (IL-6), galectin 3, growth differentiation factor 15 (GDF-15), and soluble ST2 (sST2) in an unselected cohort of critically ill patients.Methods: During a study period of 1 year, we recruited 530 consecutive patients admitted to a medical intensive care unit of a tertiary care hospital. We examined a combination of inflammatory, renal, and cardiac biomarkers for the prediction of 90-day all-cause mortality.Results: During follow-up, 118 patients died (22%). In univariate analyses, increased IL-6, galectin 3, GDF-15, and sST2 plasma concentrations at baseline were strong prognostic markers. However, in the multivariate models, only IL-6 and sST2 remained independent biomarkers adding additional prognostic information to the routinely used Simplified Acute Physiology Score (SAPS) II. Using a simple multimarker approach, patients with increased SAPS II, IL-6, and sST2 (ie, SAPS II >35, IL-6 >32.3 pg/mL, and sST2 >103 ng/mL) had the poorest outcome.Conclusions: In this heterogeneous group of critically ill patients, only SAPS II, IL-6, and sST2 remained independent and additive prognosticmarkers for 90-day all-causemortality. A combination of the SAPS II with the 2 complementary biomarkers might provide a valuable tool for risk stratification of critically ill patients. (C) 2016 The Authors. Published by Elsevier Inc.