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 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.
Cheng
Wei-Erh
WE
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
Shih
Chuen-Ming
CM
Hang
Liang-Wen
LW
Wu
Kuen-Yuh
KY
Yang
Hsin-Ling
HL
Hsu
Wu-Huei
WH
Hsia
Te-Chun
TC
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
D015415:Biomarkers; D003839:Deoxyadenosines