title: Soluble Urokinase Plasminogen Activator Receptor: A New Biomarker in the Pediatric Intensive Care Unit.
abstract: OBJECTIVE
  To evaluate the value of soluble urokinase plasminogen activator receptor (suPAR) in diagnosing sepsis and predicting mortality in critically ill children.
  
  
  METHODS
  In a prospective cohort study, 69 critically ill children admitted into the pediatric intensive care unit (PICU) were randomly enrolled in addition to 15 healthy children as a control group. Clinical examination was performed, including calculation of the Pediatric Risk of Mortality (PRISM) and Pediatric Index of Mortality2 (PIM2). suPAR was measured in patients at admission as well as in the controls. Patients were followed up for 30 d.
  
  
  RESULTS
  suPAR level was significantly higher among the total patient cohort compared to controls (p < 0.0001). suPAR was also significantly higher among patients with sepsis compared to both controls (p < 0.0001) and patients without sepsis (p < 0.0001). Furthermore, suPAR level was significantly elevated in non-survivors compared to survivors (p 0.008). Receiver operating characteristic curve (ROC curve) analysis revealed an area under the curve (AUC) of 0.80 for suPAR for diagnosis of sepsis while C-reactive protein (CRP) had an AUC of 0.82. Regarding the prognosis, suPAR had an AUC of 0.69 for prediction of mortality, whereas the AUC for PRISM, PIM2, and CRP were 0.82, 0.81, and 0.77 respectively.
  
  
  CONCLUSIONS
  suPAR has both a diagnostic and a prognostic value for critically ill children. However, it does not seem to be superior to the classic laboratory markers and clinical scoring systems.
authors.affiliation: Department of Pediatrics, Menoufia University, Menoufia, Egypt. mekkawy55@gmail.com.
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: El-Mekkawy
authors.affiliation: Department of Pediatrics, Menoufia University, Menoufia, Egypt.
authors.forename: Nagwan Y
authors.initials: NY
authors.lastname: Saleh
authors.affiliation: Department of Clinical Pathology, Menoufia University, Menoufia, Egypt.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Sonbol
mesh_terms: D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D016638:Critical Illness; D006801:Humans; D015278:Intensive Care Units, Pediatric; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood*; D018805:Sepsis / Q000175:diagnosis* / Q000401:mortality
chemical_list: D015415:Biomarkers; D055293:Receptors, Urokinase Plasminogen Activator; D002097:C-Reactive Protein
keywords: Children; Intensive care unit; Sepsis biomarker; Soluble urokinase plasminogen activator receptor; Systemic inflammatory response syndrome