title: Plasma chromogranin A after severe burn trauma.
abstract: BACKGROUND
  Chromogranin A (CgA) in plasma (P-CgA), a neuroendocrine marker of sympathetic stress, has been shown to predict mortality in medical intensive care. We hypothesized that the magnitude of CgA release would reflect stress load, and thereby injury severity in burn intensive care patients.
  
  
  METHODS
  Fifty-one consecutive patients with a burn area exceeding 10% were included. P-CgA was measured twice daily for seven days after injury. The point value at 24h, the mean and maximum values and the AUC at days 1-7, were tested as possible predictors. Injury severity in the form of organ dysfunction was measured as SOFA score at day 7.
  
  
  RESULTS
  P-CgA could be classified into two types with respect to variability over time. Patients with high variability had more deep injuries and were older than those with low variability. All measures of CgA correlated with SOFA score at day 7, but not with total burn size. Univariate regressions showed that age, burn size and three of four measures of P-CgA predicted organ dysfunction. Multiple regressions showed that age, burn size, and either P-CgA at 24h, the mean value up to day 7, or the maximum value up to day 7, were independent predictors for organ dysfunction. Significant organ dysfunction was best predicted by age, burn area and the CgA point value at 24h with an AUC value of 0.91 in a ROC-analysis.
  
  
  CONCLUSIONS
  The extent of neuroendocrine activation assessed as P-CgA after a major burn injury is independently related to organ dysfunction.
authors.affiliation: Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Andreas E
authors.initials: AE
authors.lastname: Lindahl
authors.forename: Aili
authors.initials: A
authors.lastname: Low
authors.forename: Mats
authors.initials: M
authors.lastname: Stridsberg
authors.forename: Folke
authors.initials: F
authors.lastname: Sjöberg
authors.forename: Lisa
authors.initials: L
authors.lastname: Ekselius
authors.forename: Bengt
authors.initials: B
authors.lastname: Gerdin
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood*; D002056:Burns / Q000378:metabolism* / Q000503:physiopathology; D053379:Chromogranin A / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000503:physiopathology; D009490:Neurosecretory Systems / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D053379:Chromogranin A