Plasma proenkephalin A 119–159 on intensive care unit admission is a predictor of organ failure and 30-day mortality

Intensive Care Medicine Experimental

Martin Annborn¹  Niklas Nielsen¹  Martin Spångfors²  Tobias Cronberg³  Patrik Johnsson⁴  Oscar H. M. Lundberg⁴  Hans Friberg⁴  Maria Lengquist⁵  Attila Frigyesi⁵  Lisa Boström⁵  Helena Levin⁶ 

[1] Department of Clinical Sciences, Anaesthesiology and Intensive Care, Lund University, 22185, Lund, Sweden;Helsingborg Hospital, Anaesthesia and Intensive Care, 25187, Helsingborg, Sweden;Department of Clinical Sciences, Anaesthesiology and Intensive Care, Lund University, 22185, Lund, Sweden;Kristianstad Central Hospital, Anaesthesia and Intensive Care, 29185, Kristianstad, Sweden;Department of Clinical Sciences, Anaesthesiology and Intensive Care, Lund University, 22185, Lund, Sweden;Skåne University Hospital, Department of Neurology, 22185, Lund, Sweden;Department of Clinical Sciences, Anaesthesiology and Intensive Care, Lund University, 22185, Lund, Sweden;Skåne University Hospital, Intensive and Perioperative Care, 21428, Malmö, Sweden;Department of Clinical Sciences, Anaesthesiology and Intensive Care, Lund University, 22185, Lund, Sweden;Skåne University Hospital, Intensive and Perioperative Care, 22185, Lund, Sweden;Department of Clinical Sciences, Anaesthesiology and Intensive Care, Lund University, 22185, Lund, Sweden;Skåne University Hospital, Research and Education, 22185, Lund, Sweden;

关键词: Proenkephalin;    Biomarker;    Intensive care;    Mortality;    Organ dysfunction;   

DOI  :  10.1186/s40635-021-00396-6

来源: Springer

【 摘 要 】

BackgroundProenkephalin A 119-159 (penKid) has been suggested as a marker of renal failure and poor outcome. We aimed to investigate the association of penKid on ICU admission with organ dysfunction and mortality in a mixed ICU population. In this retrospective, observational study, admission penKid levels from prospectively collected blood samples of consecutive patients admitted to four Swedish ICUs were analysed. The association of penKid with day-two sequential organ failure assessment (SOFA) scores and 30-day mortality was investigated using (ordinal) logistic regression. The predictive power of penKid for 30-day mortality and dialysis was assessed using the area under the receiver operating characteristic curve (AUC).ResultsOf 1978 included patients, 632 fulfilled the sepsis 3-criteria, 190 had a cardiac arrest, and 157 had experienced trauma. Admission penKid was positively associated with 30-day mortality with an odds ratio of 1.95 (95% confidence interval 1.75–2.18, p < 0.001), and predicted 30-day mortality in the entire ICU population with an AUC of 0.71 (95% confidence interval 0.68–0.73) as well as in the sepsis, cardiac arrest and traumasubgroups (AUCs of 0.61–0.84). Correction for admission plasma creatinine revealed that penKid correlated with neurological dysfunction.ConclusionPlasma penKid on ICU admission is associated with day-two organ dysfunction and predictive of 30-day mortality in a mixed ICU-population, as well as in sepsis, cardiac arrest and trauma subgroups. In addition to being a marker of renal dysfunction, plasma penKid is associated with neurologic dysfunction in the entire ICU population, and cardiovascular dysfunction in sepsis.

【 授权许可】

CC BY