Chase T Schultz-Swarthfigure1, Philip McCall1,2, Robert Docking3, Helen F Galley4, Benjamin Shelley1,2. 1. University Department of Anaesthesia, Pain and Intensive Care Medicine, New Lister Building, Glasgow Royal Infirmary, Glasgow, UK. 2. Department of Anaesthesia, Golden Jubilee National Hospital, Glasgow, UK. 3. Department of Anaesthesia, Queen Elizabeth University Hospital, Glasgow, UK. 4. Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK.
Abstract
OBJECTIVES: Soluble urokinase plasminogen activator receptor (suPAR) is a biomarker that has been implicated in several cardiac pathologies and has been shown to be elevated in critically ill populations. We measured plasma suPAR in a cohort of cardiac surgical patients to evaluate its ability to predict prolonged intensive care unit (ICU) and hospital length of stay and development of complications following surgery. We compared suPAR against EuroSCORE II and C-reactive protein (CRP). METHODS: Ninety patients undergoing cardiac surgery were recruited with samples taken preoperatively and on postoperative days 1, 2 and 3. suPAR was measured using enzyme-linked immunosorbent assay. Area under the receiver operator curve (AUROC) was used to test predictive capability of suPAR. Comparison was made with EuroSCORE II and CRP. RESULTS: suPAR increased over time (P < 0.001) with higher levels in patients requiring prolonged ICU and hospital stay, and prolonged ventilation (P < 0.05). suPAR was predictive for prolonged ICU and hospital stay, and prolonged ventilation at all time points (AUROC 0.66-0.74). Interestingly, this association was also observed preoperatively, with preoperative suPAR predicting prolonged ICU (AUROC 0.66), and hospital stay (AUROC 0.67) and prolonged ventilation (AUROC 0.74). The predictive value of preoperative suPAR compared favourably to EuroSCORE II and CRP. CONCLUSIONS: suPAR increases following cardiac surgery and levels are higher in those who require prolonged ICU stay, prolonged hospital stay and prolonged ventilation. Preoperative suPAR compares favourably to EuroSCORE II and CRP in the prediction of these outcomes. suPAR could be a useful biomarker in predicting outcome following cardiac surgery, helping inform clinical decision-making. CLINICAL REGISTRATION: West of Scotland Research Ethics Committee Reference: 12/WS/0179 (AM01).
OBJECTIVES: Soluble urokinase plasminogen activator receptor (suPAR) is a biomarker that has been implicated in several cardiac pathologies and has been shown to be elevated in critically ill populations. We measured plasma suPAR in a cohort of cardiac surgical patients to evaluate its ability to predict prolonged intensive care unit (ICU) and hospital length of stay and development of complications following surgery. We compared suPAR against EuroSCORE II and C-reactive protein (CRP). METHODS: Ninety patients undergoing cardiac surgery were recruited with samples taken preoperatively and on postoperative days 1, 2 and 3. suPAR was measured using enzyme-linked immunosorbent assay. Area under the receiver operator curve (AUROC) was used to test predictive capability of suPAR. Comparison was made with EuroSCORE II and CRP. RESULTS: suPAR increased over time (P < 0.001) with higher levels in patients requiring prolonged ICU and hospital stay, and prolonged ventilation (P < 0.05). suPAR was predictive for prolonged ICU and hospital stay, and prolonged ventilation at all time points (AUROC 0.66-0.74). Interestingly, this association was also observed preoperatively, with preoperative suPAR predicting prolonged ICU (AUROC 0.66), and hospital stay (AUROC 0.67) and prolonged ventilation (AUROC 0.74). The predictive value of preoperative suPAR compared favourably to EuroSCORE II and CRP. CONCLUSIONS: suPAR increases following cardiac surgery and levels are higher in those who require prolonged ICU stay, prolonged hospital stay and prolonged ventilation. Preoperative suPAR compares favourably to EuroSCORE II and CRP in the prediction of these outcomes. suPAR could be a useful biomarker in predicting outcome following cardiac surgery, helping inform clinical decision-making. CLINICAL REGISTRATION: West of Scotland Research Ethics Committee Reference: 12/WS/0179 (AM01).
Authors: Roelof G A Ettema; Linda M Peelen; Marieke J Schuurmans; Arno P Nierich; Cor J Kalkman; Karel G M Moons Journal: Circulation Date: 2010-08-02 Impact factor: 29.690
Authors: Gethin W Hodges; Casper N Bang; Kristian Wachtell; Jesper Eugen-Olsen; Jørgen L Jeppesen Journal: Can J Cardiol Date: 2015-03-25 Impact factor: 5.223
Authors: Damien J LaPar; Alan M Speir; Ivan K Crosby; Edwin Fonner; Michael Brown; Jeffrey B Rich; Mohammed Quader; John A Kern; Irving L Kron; Gorav Ailawadi Journal: Ann Thorac Surg Date: 2014-08 Impact factor: 4.330
Authors: B Suberviola; A Castellanos-Ortega; A Ruiz Ruiz; M Lopez-Hoyos; M Santibañez Journal: Intensive Care Med Date: 2013-08-16 Impact factor: 17.440
Authors: Waldemar Gozdzik; Barbara Adamik; Anna Gozdzik; Maciej Rachwalik; Wojciech Kustrzycki; Andrzej Kübler Journal: PLoS One Date: 2014-06-09 Impact factor: 3.240
Authors: Helena Enocsson; Cornelia Idoff; Annette Gustafsson; Melissa Govender; Francis Hopkins; Marie Larsson; Åsa Nilsdotter-Augustinsson; Johanna Sjöwall Journal: Front Med (Lausanne) Date: 2021-12-02