Association of cell-free plasma DNA with hospital mortality and organ dysfunction in intensive care unit patients
Association of cell-free plasma DNA with hospital mortality and organ dysfunction in intensive care unit patients
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DOI：
10.1007/s00134-007-0686-z
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发表时间：
2007-09-01
影响因子：
38.9
通讯作者：
Pulkki, Kari
中科院分区：
文献类型：
--
作者：
Saukkonen, Katri;Lakkisto, Paeivi;Pulkki, Kari
目的：探讨重症监护病房患者血浆游离 DNA 浓度及其与器官功能障碍和医院死亡率的关系。设计和设置：在大学医院的一个内科和两个内外科重症监护病房进行前瞻性队列研究。患者：2004年1月至2005年7月入住ICU的228名危重患者。测量和结果：入ICU后尽快采集血样，第二天早上，以及第二次采样后48小时采集血样。通过实时定量PCR测定来测量无细胞血浆DNA的β-珠蛋白基因。生理和死亡率数据被收集到临床数据库中。医院死亡率和 SOFA 评分是主要结局指标。最大血浆 DNA 浓度与 APACHE II 分数和最大 SOFA 分数显着相关。医院非幸存者中的无细胞血浆 DNA 浓度高于幸存者（中位数 9,366 GE/ml vs. 6,506 GE/ml）。使用逻辑回归分析，最大血浆 DNA 是医院死亡率的独立预测因子。结论：重症监护前 96 小时内测得的最大血浆 DNA 浓度与器官功能障碍程度和疾病严重程度相关。此外，最大 DNA 浓度与医院死亡率独立相关。
Objective: To investigate the concentration of cell- free plasma DNA and its association with organ dysfunction and hospital mortality in intensive care unit patients. Design and setting: Prospective cohort study in a medical and two medical- surgical intensive care units in a university hospital. Patients: 228 critically ill patients admitted to the ICUs between January 2004 and July 2005. Measurements and results: Blood samples were collected as soon as possible after ICU admission, the following morning, and 48 h after the second sample. The cell- free plasma DNA was measured by real- time quantitative PCR assay for the beta- globin gene. Physiological and mortality data were collected to the clinical database. Hospital mortality rate and SOFA scores were primary outcome measures. The maximum plasma DNA concentrations were correlated significantly with APACHE II points and with maximum SOFA scores. Cell- free plasma DNA concentrations were higher in hospital non- survivors than in survivors ( median 9,366 vs. 6,506 GE/ ml). Using logistic regression analysis, the maximum plasma DNA was an independent predictor of hospital mortality. Conclusions: The maximum plasma DNA concentration measured during the first 96 h of intensive care is associated with the degree of organ dysfunction and disease severity. Moreover, the maximum DNA concentration is independently associated with hospital mortality.