title: Usefulness of suPAR in the risk stratification of patients with sepsis admitted to the emergency department.
abstract: To investigate the role of suPAR in patients with sepsis admitted to the Emergency Department (ED). We performed multicentre prospective trial including patients admitted to the ED of three different Italian hospitals. Patients were studied upon admission on day 1, 2, 4 and 7. They were subdivided into two groups: sepsis (group 1) and severe sepsis or septic shock (group 2). The two groups were comparable for age, gender and CRP level on day 1. Patients with severe sepsis or septic shock displayed significantly higher baseline levels of suPAR, PCT and lactate. In both groups, suPAR decreased across the time (p < 0.0005). Group 1 was not different from group 2 (p = 0.545) in mortality at 7 days, while group 2 had higher mortality at 30 days than group 1 (p = 0.022). At the multivariate analysis, lactate1 (p = 0.012) and age (p = 0.019) were independent predictors of mortality at 7 days, whereas suPAR1 (p = 0.023) and age (p = 0.032) were independent predictors of mortality at 30 days. Lactate and suPAR resulted the most predictive biomarkers in the risk stratification of patients with suspected infection initially admitted to the ED, according to their role in predicting 7- and 30-day mortality, respectively.
authors.affiliation: Emergency Department, SS. Antonio e Biagio e Cesare Arrigo Hospital, Via Venezia 16, 15100, Alessandria, Italy, icasagranda@ospedale.al.it.
authors.forename: Ivo
authors.initials: I
authors.lastname: Casagranda
authors.forename: Chiara
authors.initials: C
authors.lastname: Vendramin
authors.forename: Tiziana
authors.initials: T
authors.lastname: Callegari
authors.forename: Matteo
authors.initials: M
authors.lastname: Vidali
authors.forename: Alessandra
authors.initials: A
authors.lastname: Calabresi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Ferrandu
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Cervellin
authors.forename: Mario
authors.initials: M
authors.lastname: Cavazza
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippi
authors.forename: Isabella
authors.initials: I
authors.lastname: Zanotti
authors.forename: Sophie
authors.initials: S
authors.lastname: Negro
authors.forename: Andrea
authors.initials: A
authors.lastname: Rocchetti
authors.forename: Carlo
authors.initials: C
authors.lastname: Arfini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D010446:Peptide Fragments / Q000032:analysis / Q000097:blood / Q000378:metabolism*; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000032:analysis / Q000097:blood; D018570:Risk Assessment; D018805:Sepsis / Q000175:diagnosis* / Q000276:immunology; D014568:Urokinase-Type Plasminogen Activator / Q000032:analysis / Q000097:blood / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011498:Protein Precursors; D014568:Urokinase-Type Plasminogen Activator; C489333:acetyl-lysyl-prolyl-seryl-seryl-prolyl-prolyl-glutamyl-glutamic acid amide