title: Prognostic impact of the serum heart-type fatty acid-binding protein (H-FABP) levels in patients admitted to the non-surgical intensive care unit.
abstract: BACKGROUND
  Biomarkers predicting adverse outcomes in non-surgical intensive care patients have not been reported.
  
  
  RESULTS
  Data for 1,006 emergency department patients were prospectively analyzed. The serum heart-type fatty acid-binding protein (s-H-FABP) level was measured within 10 min of admission. The patients were assigned to intensive care (n = 835) or other departments (n = 171). The intensive care patients were divided into survivors (n = 745) and non-survivors (n = 90) according to the in-hospital mortality and assigned to four groups according to the quartiles of s-H-FABP (Q1, Q2, Q3 and Q4). The s-H-FABP levels were significantly higher in the intensive care patients (12.7 [6.1-38.8] ng/ml versus 5.3 [3.1-9.4] ng/ml) and in the non-survivors (44.9 [23.2-87.6] ng/ml versus 11.5 [5.6-32.6] ng/ml). A Kaplan-Meier curve showed a significantly higher survival rate in Q3 than in Q1 and Q2 and in Q4 than in the other groups. The multivariate Cox regression model identified Q3 (HR 4.646, 95 % CI 1.526-14.146) and Q4 (HR 9.483, 95 % CI 3.152-28.525) as independent predictors of 90-day mortality. The sensitivity and specificity of H-FABP for in-hospital mortality were 81.1 and 66.0 % (AUC 0.775) at 20.95 ng/ml. The in-hospitality rate was significantly higher in the high s-H-FABP patients than in the low s-H-FABP patients in each etiology group.
  
  
  CONCLUSIONS
  The s-H-FABP level is an effective biomarker for risk stratification in non-surgical intensive care patients.
authors.affiliation: Division of Intensive Care Unit, Nippon Medical School, Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan, s6042@nms.ac.jp.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shirakabe
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Noritake
authors.initials: N
authors.lastname: Hata
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Takuro
authors.initials: T
authors.lastname: Shinada
authors.forename: Kazunori
authors.initials: K
authors.lastname: Tomita
authors.forename: Masafumi
authors.initials: M
authors.lastname: Tsurumi
authors.forename: Masato
authors.initials: M
authors.lastname: Matsushita
authors.forename: Hirotake
authors.initials: H
authors.lastname: Okazaki
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Shinya
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Kuniya
authors.initials: K
authors.lastname: Asai
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D013504:Cardiovascular Surgical Procedures; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006331:Heart Diseases / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013503:Surgery Department, Hospital; D015996:Survival Rate
chemical_list: D015415:Biomarkers; C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins