The predictive value of modified soluble urokinase plasminogen activator receptor (suPAR) with National Early Warning Score (NEWS) for mortality in emergency elderly patients in Japan: a prospective pilot study.
The predictive value of modified soluble urokinase plasminogen activator receptor (suPAR) with National Early Warning Score (NEWS) for mortality in emergency elderly patients in Japan: a prospective pilot study.
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DOI：
10.1002/ams2.840
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发表时间：
2023-01
影响因子：
1.6
通讯作者：
Takeda, Satoshi
中科院分区：
文献类型：
--
作者：
Mitsunaga, Toshiya;Ohtaki, Yuhei;Seki, Yutaka;Mashiko, Kunihiro;Uzura, Masahiko;Okuno, Kenji;Takeda, Satoshi
本研究的目的是评估溶性尿激酶纤溶酶原激活物受体（suPAR）和改良suPAR与国家预警评分（NEWS）在70岁以上老年急诊患者中检测死亡率的能力。这是对我们先前研究的二次分析，该研究是一项单中心前瞻性试点研究，在日本一家二级急救机构的急诊科进行了21个月的研究。这项研究在2020年9月16日至2022年6月21日期间进行。该研究包括所有70岁及以上到急诊科就诊的无创伤患者。通过绘制受者-工作特征曲线并计算受者-工作特征曲线下面积（AUC）来评估鉴别性。研究期间纳入47例符合条件的老年患者，其中死亡8例（17.0%）。存活组的中位suPAR显著低于非存活组（P < 0.01）。suPAR预测死亡率的AUC为0.805（95%置信区间为0.633 ~ 0.949,P < 0.001）。改良suPAR与NEWS对死亡率的AUC高于suPAR[0.865]（95%可信区间0.747 ~ 0.958,P < 0.001）。我们的单中心研究表明，改良suPAR与NEWS作为老年急诊患者死亡率的预测工具具有很高的实用性。需要多中心研究的证据才能在急诊科环境中引入带有NEWS的改良suPAR。本研究的目的是评估改良suPAR与国家预警评分（NEWS）在检测70岁以上老年急诊患者死亡率方面的能力。我们的单中心研究表明，改良suPAR与NEWS作为老年急诊患者死亡率的预测工具具有很高的实用性。
The aim of this study is to evaluate the ability of soluble urokinase plasminogen activator receptor (suPAR) and modified suPAR with National Early Warning Score (NEWS) for detecting mortality in elderly emergency patients who are older than 70 years. This is a secondary analysis of our previous study, which was a single‐center prospective pilot study, carried out for 21 months in the emergency department of a secondary emergency institution in Japan. This study was carried out between September 16, 2020, and June 21, 2022. The study included all patients without trauma aged 70 years or older who presented to the emergency department. Discrimination was assessed by plotting the receiver‐operating characteristic curve and calculating the area under the receiver‐operating characteristic curve (AUC). During the study period, 47 eligible older patients were included, among which 8 (17.0%) patients died. The median suPAR was significantly lower in the survivor's group than in the nonsurvivor's group (P < 0.01). For suPAR, the AUC for the prediction of mortality was 0.805 (95% confidence interval 0.633–0.949, P < 0.001). The AUC of modified suPAR with NEWS for mortality was higher than that of suPAR [0.865 (95% confidence interval 0.747–0.958, P < 0.001)]. Our single‐center study has demonstrated the high utility of modified suPAR with NEWS as a predictive tool of mortality in elderly emergency patients. Evidence from multicenter studies is needed for introducing modified suPAR with NEWS in the emergency department setting. The aim of this study is to evaluate the ability of modified suPAR with National Early Warning Score (NEWS) for detecting mortality in elderly emergency patients who are older than 70 years. Our single‐center study has demonstrated the high utility of modified suPAR with NEWS as a predictive tool of mortality in elderly emergency patients.