Soluble ST2 as a prognostic marker in community-acquired pneumonia - 11/04/15
, Hajime Takizawa a, Masaki Tamura a, Akira Nakajima a, Daisuke Kurai a, Haruyuki Ishii a, Saori Takata a, Keitaro Nakamoto a, Erei Sohara a, Koujirou Honda a, Masuo Nakamura a, Toshiya Inui a, Hiroo Wada a, Hajime Goto aSummary |
Objectives |
Community-acquired pneumonia (CAP) is associated with high mortality when initial treatment fails. Early identification of these patients allows physicians to modify treatments earlier, increasing survival.
Methods |
Ninety-one hospitalized patients with CAP were studied. Serum soluble ST2 levels were measured at diagnosis and at 3, 7, and 14 days (days 0, 3, 7, and 14) after the initiation of antimicrobial treatment. The predictive value of all-cause in-hospital mortality and the additive effect of soluble ST2 on the pneumonia severity index (PSI) were evaluated.
Results |
In univariate analysis, high serum levels of soluble ST2 at days 0, 3, 7, and 14 were predictive of death (hazard ratios: 3.1, 10.0, 12.0, and 22.6, respectively). In multivariate analysis, a combination of soluble ST2 at day 3 (above 2700 pg/ml) and PSI were predictive of death with higher accuracy than PSI alone (net reclassification improvement, 0.44; integrated discrimination improvement, 0.17; P = 0.001 for both). Specifically, simultaneous presence of high soluble ST2 (day 3) and a PSI of 5 was suggestive of higher mortality risk than a PSI of 5 alone (mortality 78% vs. 39%, respectively).
Conclusions |
Soluble ST2 is prognostic indicator of CAP and can add to the predictive value of the PSI.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Suppression of tumorigenicity 2 (ST2) is a receptor for interleukin (IL)-33. |
• | sST2 is a predictor of all-cause in-hospital mortality of community acquired pneumonia. |
• | Combination of sST2 plus the Pneumonia Severity Score (PSI) is superior to PSI alone as a mortality predictor. |
Keywords : Suppression of tumorigenicity 2, Biomarker, Infection, Treatment, Severity
Abbreviation : AUC, CAP, CRP, GVHD, ICU, IL, PSI, ROC, ST2, WBC
Plan
Vol 70 - N° 5
P. 474-482 - mai 2015 Retour au numéro
Article précédent
- Predictors of recurrent cellulitis in five years. Clinical risk factors and the role of PTX3 and CRP
- Matti Karppelin, Tuula Siljander, Janne Aittoniemi, Mikko Hurme, Reetta Huttunen, Heini Huhtala, Juha Kere, Jaana Vuopio, Jaana Syrjänen
- Microbiological analysis of bile and its impact in critically ill patients with secondary sclerosing cholangitis
- Torsten Voigtländer, Ensieh Leuchs, Ralf-Peter Vonberg, Philipp Solbach, Michael P. Manns, Sebastian Suerbaum, Tim O. Lankisch
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?