Urinary biomarker of oxidative stress correlating with outcome in critically septic patients.
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.


METHODS
Clinical outcome study in an adult medical intensive care unit (ICU).


METHODS
85 consecutive septic patients (59 men, 26 women).


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.
Cheng
Wei-Erh
WE
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, 2 Yuh-Der Rd., Taichung 404, Taiwan.
Shih
Chuen-Ming
CM
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, 2 Yuh-Der Rd., Taichung 404, Taiwan.
Hang
Liang-Wen
LW
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, 2 Yuh-Der Rd., Taichung 404, Taiwan.
Wu
Kuen-Yuh
KY
Division of Environmental Health and Occupational Medicine, National Health Research Institute, 35, Keyan Road, Zhunan Town, Miaoli County 350, Taiwan.
Yang
Hsin-Ling
HL
Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, Taichung 404, Taiwan.
Hsu
Wu-Huei
WH
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, 2 Yuh-Der Rd., Taichung 404, Taiwan.
Hsia
Te-Chun
TC
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.
D000080242:8-Hydroxy-2'-Deoxyguanosine; D018806:APACHE; D000368:Aged; D015415:Biomarkers / Q000652:urine*; D002853:Chromatography, Liquid; D016638:Critical Illness; D003849:Deoxyguanosine / Q000031:analogs & derivatives* / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D018384:Oxidative Stress; D011865:Radioisotope Dilution Technique; D018805:Sepsis / Q000401:mortality* / Q000652:urine; D053719:Tandem Mass Spectrometry
D015415:Biomarkers; D000080242:8-Hydroxy-2'-Deoxyguanosine; D003849:Deoxyguanosine