title: Serum concentration of chromogranin A at admission: an early  biomarker of severity in critically ill patients.
abstract: BACKGROUND
  Chromogranin A (CGA), a stress marker released with catecholamines by the adrenal medulla, has never been associated with acute inflammation in critically ill patients.
  
  
  OBJECTIVE
  To determine evidence for a link between serum concentration of CGA, biomarkers of inflammation, and outcome inpatients admitted with or without the systemic inflammatory response syndrome (SIRS).
  
  
  METHODS
  At admission, we measured in 53 patients and 14 healthy controls the serum concentrations of CGA,procalcitonin, and C-reactive protein. We also assessed the Simplified Acute Physiological Score (SAPS) in the patients.
  
  
  RESULTS
  Serum CGA concentrations were significantly increased in SIRS patients with a median value of 115 microg/L (68.0-202.8), when compared to healthy controls (PB0.001). In cases where infection was associated with SIRS, patients had the highest increase in CGA with a median value of 138.5 microg/L (65-222.3) (PB0.001). CGA concentrations positively correlated with inflammation markers (procalcitonin, C-reactive protein), but also with SAPS. Receiver operating characteristic (ROC) analysis showed that CGA is equivalent to SAPS as an indicator for 28-day mortality (area under curve (AUC) for both: 0.810).
  
  
  CONCLUSIONS
  Patients with CGA concentration superior to 71 microg/L have a significantly shorter survival. A Cox model confirmed that CGA and SAPS were independent predictors of outcome.
authors: Réanimation Médicale, Hôpital de Hautepierre, Strasbourg, France.
authors: Dan
authors: D
authors: Zhang
authors: Thomas
authors: T
authors: Lavaux
authors: Rémy
authors: R
authors: Sapin
authors: Thierry
authors: T
authors: Lavigne
authors: Vincent
authors: V
authors: Castelain
authors: Dominique
authors: D
authors: Aunis
authors: Marie-Hélène
authors: MH
authors: Metz-Boutigue
authors: Francis
authors: F
authors: Schneider
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D053379:Chromogranin A / Q000097:blood*; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood; D012372:ROC Curve; D012720:Severity of Illness Index; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis* / Q000401:mortality*
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D053379:Chromogranin A; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide