Wei-Erh Cheng1, Chuen-Ming Shih1, Liang-Wen Hang1, Kuen-Yuh Wu2, Hsin-Ling Yang3, Wu-Huei Hsu1, Te-Chun Hsia4. 1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, 2 Yuh-Der Rd., Taichung 404, Taiwan. 2. Division of Environmental Health and Occupational Medicine, National Health Research Institute, 35, Keyan Road, Zhunan Town, Miaoli County 350, Taiwan. 3. Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, Taichung 404, Taiwan. 4. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, 2 Yuh-Der Rd., Taichung 404, Taiwan. derrick.hsia@msa.hinet.net.
Abstract
OBJECTIVE: To determine whether urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG), an in vivo parameter of oxidative stress, is correlated with the outcome of critically septic patients. DESIGN AND SETTING: Clinical outcome study in an adult medical intensive care unit (ICU). PATIENTS: 85 consecutive septic patients (59 men, 26 women). MEASUREMENTS AND RESULTS: Patient characteristics and the clinical course were examined. Urinary 8-OHdG was analyzed using isotope-dilution liquid chromatography with tandem mass spectrometry (LC/MS/MS). ICU mortality was 25.9% (22/85) and hospital mortality 38.8% (33/85). Survivors' APACHEII scores on days 1 and 3 and the difference between them differed significantly from those of nonsurvivors (day 1, 21.0+/-7.1 vs. 25.9+/-8.0; day 3, 15.0+/-5.8 vs. 23.2+/-8.3; difference, 6.0+/-5.5 vs. 1.7+/-6.6). Urinary 8-OHdG was significantly lower in survivors than in nonsurvivors on day 1 (1.8+/-2.4 vs. 3.0+/-2.4). The area under receiver operating characteristic curve analysis for the association between day 1 urinary 8-OHdG and ICU mortality was 0.71. The comparison performed upon discharge from hospital revealed similar results. CONCLUSIONS: This is a preliminary study. Excretion of urinary 8-OHdG, as measured using isotope-dilution LC/MS/MS, and the APACHE II score were correlated with the outcome of critically septic patients in medical ICU.
OBJECTIVE: To determine whether urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG), an in vivo parameter of oxidative stress, is correlated with the outcome of critically septicpatients. DESIGN AND SETTING: Clinical outcome study in an adult medical intensive care unit (ICU). PATIENTS: 85 consecutive septic patients (59 men, 26 women). MEASUREMENTS AND RESULTS:Patient characteristics and the clinical course were examined. Urinary 8-OHdG was analyzed using isotope-dilution liquid chromatography with tandem mass spectrometry (LC/MS/MS). ICU mortality was 25.9% (22/85) and hospital mortality 38.8% (33/85). Survivors' APACHEII scores on days 1 and 3 and the difference between them differed significantly from those of nonsurvivors (day 1, 21.0+/-7.1 vs. 25.9+/-8.0; day 3, 15.0+/-5.8 vs. 23.2+/-8.3; difference, 6.0+/-5.5 vs. 1.7+/-6.6). Urinary 8-OHdG was significantly lower in survivors than in nonsurvivors on day 1 (1.8+/-2.4 vs. 3.0+/-2.4). The area under receiver operating characteristic curve analysis for the association between day 1 urinary 8-OHdG and ICU mortality was 0.71. The comparison performed upon discharge from hospital revealed similar results. CONCLUSIONS: This is a preliminary study. Excretion of urinary 8-OHdG, as measured using isotope-dilution LC/MS/MS, and the APACHE II score were correlated with the outcome of critically septicpatients in medical ICU.
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