title: Urinary biomarker of oxidative stress correlating with outcome in critically septic patients.
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.
  
  
  METHODS
  Clinical outcome study in an adult medical ICU.
  
  
  METHODS
  Eighty-five consecutive septic patients: 59 men and 26 women.
  
  
  RESULTS
  Urinary 8-OHdG was analyzed using isotope-dilution liquid chromatography with tandem mass spectrometry (LC/MS/MS). ICU mortality in these 85 septic patients was 25.9% (n = 22) and hospital mortality 38.8% (n = 33). APACHE II scores of survivors on day 1, on day 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. The excretion of the urinary 8-OHdG, as measured using isotope-dilution LC/MS/MS, as the APACHE II score, were correlated with the outcome of critically septic patients in medical ICU.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, 2 Yuh-Der Rd., 404 Taichung, Taiwan. derrick.hsia@msa.hinet.net
authors.forename: Wei-Erh
authors.initials: WE
authors.lastname: Cheng
authors.forename: Chuen-Ming
authors.initials: CM
authors.lastname: Shih
authors.forename: Liang-Wen
authors.initials: LW
authors.lastname: Hang
authors.forename: Kuen-Yuh
authors.initials: KY
authors.lastname: Wu
authors.forename: Hsin-Ling
authors.initials: HL
authors.lastname: Yang
authors.forename: Wu-Huei
authors.initials: WH
authors.lastname: Hsu
authors.forename: Te-Chun
authors.initials: TC
authors.lastname: Hsia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000652:urine; D016638:Critical Illness; D003839:Deoxyadenosines / Q000032:analysis / Q000652:urine*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D018384:Oxidative Stress / Q000502:physiology*; D012372:ROC Curve; D012772:Shock, Septic / Q000503:physiopathology*; D013624:Taiwan
chemical_list: D015415:Biomarkers; D003839:Deoxyadenosines