Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients

Abstract Background Shock and organ damage occur in critically ill patients in the emergency department because of biological responses to invasion, and cytokines play an important role in their development. It is important to predict early multiple organ dysfunction (MOD) because it is useful in pr...

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Autores principales:	Shigeto Ishikawa, Yuto Teshima, Hiroki Otsubo, Takashi Shimazui, Taka-aki Nakada, Osamu Takasu, Kenichi Matsuda, Junichi Sasaki, Masakazu Nabeta, Takeshi Moriguchi, Takayuki Shibusawa, Toshihiko Mayumi, Shigeto Oda
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Critically ill Interleukin Multiple organ dysfunction Predictive marker qSOFA Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/77ce90465686422ba2455da473150e6e
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spelling	oai:doaj.org-article:77ce90465686422ba2455da473150e6e2021-11-14T12:15:56ZRisk prediction of biomarkers for early multiple organ dysfunction in critically ill patients10.1186/s12873-021-00534-z1471-227Xhttps://doaj.org/article/77ce90465686422ba2455da473150e6e2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12873-021-00534-zhttps://doaj.org/toc/1471-227XAbstract Background Shock and organ damage occur in critically ill patients in the emergency department because of biological responses to invasion, and cytokines play an important role in their development. It is important to predict early multiple organ dysfunction (MOD) because it is useful in predicting patient outcomes and selecting treatment strategies. This study examined the accuracy of biomarkers, including interleukin (IL)-6, in predicting early MOD in critically ill patients compared with that of quick sequential organ failure assessment (qSOFA). Methods This was a multicenter observational sub-study. Five universities from 2016 to 2018. Data of adult patients with systemic inflammatory response syndrome who presented to the emergency department or were admitted to the intensive care unit were prospectively evaluated. qSOFA score and each biomarker (IL-6, IL-8, IL-10, tumor necrosis factor-α, C-reactive protein, and procalcitonin [PCT]) level were assessed on Days 0, 1, and 2. The primary outcome was set as MOD on Day 2, and the area under the curve (AUC) was analyzed to evaluate qSOFA scores and biomarker levels. Results Of 199 patients, 38 were excluded and 161 were included. Patients with MOD on Day 2 had significantly higher qSOFA, SOFA, and Acute Physiology and Chronic Health Evaluation II scores and a trend toward worse prognosis, including mortality. The AUC for qSOFA score (Day 0) that predicted MOD (Day 2) was 0.728 (95% confidence interval [CI]: 0.651–0.794). IL-6 (Day 1) showed the highest AUC among all biomarkers (0.790 [95% CI: 0.711–852]). The combination of qSOFA (Day 0) and IL-6 (Day 1) showed improved prediction accuracy (0.842 [95% CI: 0.771–0.893]). The combination model using qSOFA (Day 1) and IL-6 (Day 1) also showed a higher AUC (0.868 [95% CI: 0.799–0.915]). The combination model of IL-8 and PCT also showed a significant improvement in AUC. Conclusions The addition of IL-6, IL-8 and PCT to qSOFA scores improved the accuracy of early MOD prediction.Shigeto IshikawaYuto TeshimaHiroki OtsuboTakashi ShimazuiTaka-aki NakadaOsamu TakasuKenichi MatsudaJunichi SasakiMasakazu NabetaTakeshi MoriguchiTakayuki ShibusawaToshihiko MayumiShigeto OdaBMCarticleCritically illInterleukinMultiple organ dysfunctionPredictive markerqSOFASpecial situations and conditionsRC952-1245Medical emergencies. Critical care. Intensive care. First aidRC86-88.9ENBMC Emergency Medicine, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Critically ill Interleukin Multiple organ dysfunction Predictive marker qSOFA Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Critically ill Interleukin Multiple organ dysfunction Predictive marker qSOFA Special situations and conditions RC952-1245 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Shigeto Ishikawa Yuto Teshima Hiroki Otsubo Takashi Shimazui Taka-aki Nakada Osamu Takasu Kenichi Matsuda Junichi Sasaki Masakazu Nabeta Takeshi Moriguchi Takayuki Shibusawa Toshihiko Mayumi Shigeto Oda Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients
description	Abstract Background Shock and organ damage occur in critically ill patients in the emergency department because of biological responses to invasion, and cytokines play an important role in their development. It is important to predict early multiple organ dysfunction (MOD) because it is useful in predicting patient outcomes and selecting treatment strategies. This study examined the accuracy of biomarkers, including interleukin (IL)-6, in predicting early MOD in critically ill patients compared with that of quick sequential organ failure assessment (qSOFA). Methods This was a multicenter observational sub-study. Five universities from 2016 to 2018. Data of adult patients with systemic inflammatory response syndrome who presented to the emergency department or were admitted to the intensive care unit were prospectively evaluated. qSOFA score and each biomarker (IL-6, IL-8, IL-10, tumor necrosis factor-α, C-reactive protein, and procalcitonin [PCT]) level were assessed on Days 0, 1, and 2. The primary outcome was set as MOD on Day 2, and the area under the curve (AUC) was analyzed to evaluate qSOFA scores and biomarker levels. Results Of 199 patients, 38 were excluded and 161 were included. Patients with MOD on Day 2 had significantly higher qSOFA, SOFA, and Acute Physiology and Chronic Health Evaluation II scores and a trend toward worse prognosis, including mortality. The AUC for qSOFA score (Day 0) that predicted MOD (Day 2) was 0.728 (95% confidence interval [CI]: 0.651–0.794). IL-6 (Day 1) showed the highest AUC among all biomarkers (0.790 [95% CI: 0.711–852]). The combination of qSOFA (Day 0) and IL-6 (Day 1) showed improved prediction accuracy (0.842 [95% CI: 0.771–0.893]). The combination model using qSOFA (Day 1) and IL-6 (Day 1) also showed a higher AUC (0.868 [95% CI: 0.799–0.915]). The combination model of IL-8 and PCT also showed a significant improvement in AUC. Conclusions The addition of IL-6, IL-8 and PCT to qSOFA scores improved the accuracy of early MOD prediction.
format	article
author	Shigeto Ishikawa Yuto Teshima Hiroki Otsubo Takashi Shimazui Taka-aki Nakada Osamu Takasu Kenichi Matsuda Junichi Sasaki Masakazu Nabeta Takeshi Moriguchi Takayuki Shibusawa Toshihiko Mayumi Shigeto Oda
author_facet	Shigeto Ishikawa Yuto Teshima Hiroki Otsubo Takashi Shimazui Taka-aki Nakada Osamu Takasu Kenichi Matsuda Junichi Sasaki Masakazu Nabeta Takeshi Moriguchi Takayuki Shibusawa Toshihiko Mayumi Shigeto Oda
author_sort	Shigeto Ishikawa
title	Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients
title_short	Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients
title_full	Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients
title_fullStr	Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients
title_full_unstemmed	Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients
title_sort	risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients
publisher	BMC
publishDate	2021
url	https://doaj.org/article/77ce90465686422ba2455da473150e6e
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Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients

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