A C Carlsson1, T Wessman2, A Larsson3, G Leijonberg2, R Tofik2, J Ärnlöv4, O Melander2, T Ruge5. 1. Division of Family Medicine and Primary Care, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden. 2. Department of Emergency and Internal Medicine, Skånes University Hospital, Malmö, Sweden; Department of Clinical Sciences Malmö, Lund University & Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden. 3. Department of Medical Sciences, Uppsala University, Uppsala, Sweden. 4. Division of Family Medicine and Primary Care, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden. 5. Department of Emergency and Internal Medicine, Skånes University Hospital, Malmö, Sweden; Department of Clinical Sciences Malmö, Lund University & Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden. Electronic address: Thoralph.Ruge@med.lu.se.
Abstract
BACKGROUND: Increased levels of circulating endostatin predicts cardiovascular morbidity and impaired kidney function in the general population. The utility of endostatin as a risk marker for mortality in the emergency department (ED) has not been reported. AIM: Our main aim was to study the association between plasma endostatin and 90-day mortality in an unselected cohort of patients admitted to the ED for acute dyspnea. Design Circulating endostatin was analyzed in plasma from 1710 adults and related to 90-day mortality in Cox proportional hazard models adjusted for age, sex, body mass index, oxygen saturation, respiratory rate, body temperature, C-reactive protein, lactate, creatinine and medical priority according to the Medical Emergency Triage and Treatment System-Adult score (METTS-A). The predictive value of endostatin for mortality was evaluated with receiver operating characteristic (ROC) analysis and compared with the clinical triage scoring system and age. RESULTS: Each one standard deviation increment of endostatin was associated with a HR of 2.12 (95% CI 1.31-3.44 p < 0.01) for 90-day mortality after full adjustment. Levels of endostatin were significantly increased in the group of patients with highest METTS-A (p < 0.001). When tested for the outcome 90-day mortality, the area under the ROC curve (AUC) was 0.616 for METTS-A, 0.701 for endostatin, 0.708 for METTS -A and age and 0.738 for METTS-A, age and levels of endostatin. CONCLUSIONS: In an unselected cohort of patients admitted to the ED with acute dyspnea, endostatin had a string association to 90-day mortality and improved prediction of 90-day mortality in the ED beyond the clinical triage scoring system and age with 3%.
BACKGROUND: Increased levels of circulating endostatin predicts cardiovascular morbidity and impaired kidney function in the general population. The utility of endostatin as a risk marker for mortality in the emergency department (ED) has not been reported. AIM: Our main aim was to study the association between plasma endostatin and 90-day mortality in an unselected cohort of patients admitted to the ED for acute dyspnea. Design Circulating endostatin was analyzed in plasma from 1710 adults and related to 90-day mortality in Cox proportional hazard models adjusted for age, sex, body mass index, oxygen saturation, respiratory rate, body temperature, C-reactive protein, lactate, creatinine and medical priority according to the Medical Emergency Triage and Treatment System-Adult score (METTS-A). The predictive value of endostatin for mortality was evaluated with receiver operating characteristic (ROC) analysis and compared with the clinical triage scoring system and age. RESULTS: Each one standard deviation increment of endostatin was associated with a HR of 2.12 (95% CI 1.31-3.44 p < 0.01) for 90-day mortality after full adjustment. Levels of endostatin were significantly increased in the group of patients with highest METTS-A (p < 0.001). When tested for the outcome 90-day mortality, the area under the ROC curve (AUC) was 0.616 for METTS-A, 0.701 for endostatin, 0.708 for METTS -A and age and 0.738 for METTS-A, age and levels of endostatin. CONCLUSIONS: In an unselected cohort of patients admitted to the ED with acute dyspnea, endostatin had a string association to 90-day mortality and improved prediction of 90-day mortality in the ED beyond the clinical triage scoring system and age with 3%.
Authors: Sana Asif; Thoralph Ruge; Anders Larsson; Sara Bülow Anderberg; Miklos Lipcsey; Robert Frithiof; Michael Hultström Journal: Biomark Med Date: 2021-10-20 Impact factor: 2.851
Authors: Per Wändell; Axel C Carlsson; Anders Larsson; Olle Melander; Torgny Wessman; Johan Ärnlöv; Toralph Ruge Journal: Ups J Med Sci Date: 2021-09-16 Impact factor: 2.384