title: Neutrophil CD64 expression is a predictor of mortality for patients in the intensive care unit.
abstract: BACKGROUND
  Neutrophil CD64 has been shown to be a promising biomarker for bacterial infection and sepsis identification. However, the prognostic value of CD64 in predicting the likelihood of survival for patients in intensive care unit (ICU) is unclear.
  
  
  METHODS
  A total of 797 patients in the ICU of Xin-Hua Hospital, Shanghai, China were enrolled. We determined the Acute Physiology and Chronic Health Evaluation II (APACHE II) scores from these patients and collected blood samples to measure the levels of neutrophil CD64, thyroid hormone and C-reactive protein (CRP). We assessed the association between APACHE II scores or these biomarkers and mortality of patients in the ICU. Receiver operating characteristic (ROC) curves were generated and the Area Under the Curve (AUC) for each indicator was determined.
  
  
  RESULTS
  The AUC for CD64 was 0.752 ± 0.026, which was higher than that of FT3 (0.696 ± 0.028) and CRP (0.672 ± 0.026). APACHE II scores had the highest AUC (0.872 ± 0.018). The level of neutrophil CD64 expression positively associated with CRP and APACHE II, and negatively correlated with FT3. Multiple regression analysis revealed that APACHE II scores (Standard β value = 0.183, P < 0.001), CD64 (Standard β value = 0.518, P < 0.001) or log (CRP) (Standard β value = 1.203, P < 0.001) independently predicted ICU mortality.
  
  
  CONCLUSIONS
  CD64 had the greatest power for predicting ICU mortality other than APACHE II scores. This result indicates that CD64 may be used as a biomarker to in combination with the use of APACHE II scores to improve the accuracy of predicting mortality outcome for patients in the ICU.
authors.affiliation: Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University Medical College Shanghai, China.
authors.forename: Qiqi
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University Medical College Shanghai, China.
authors.forename: Junfeng
authors.initials: J
authors.lastname: Shi
authors.affiliation: Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University Medical College Shanghai, China.
authors.forename: Aihua
authors.initials: A
authors.lastname: Fei
authors.affiliation: Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University Medical College Shanghai, China.
authors.forename: Feilong
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University Medical College Shanghai, China.
authors.forename: Shuming
authors.initials: S
authors.lastname: Pan
authors.affiliation: Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiaotong University School of Medicine Shanghai 200092, China.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D017452:Receptors, IgG / Q000378:metabolism*; D013963:Thyroid Hormones / Q000097:blood
chemical_list: D015415:Biomarkers; D017452:Receptors, IgG; D013963:Thyroid Hormones
keywords: ICU; Neutrophil CD64; mortality; predictor