title: Cancer Antigen 125 is Associated with Length of Stay in Patients with Acute Heart Failure.
abstract: Length of stay is the primary driver of heart-failure hospitalization costs. Because cancer antigen 125 has been associated with poor morbidity and mortality rates in heart failure, we investigated the relationship between admission cancer antigen 125 levels and lengths of stay in heart-failure patients. A total of 267 consecutive patients (184 men, 83 women) with acute decompensated heart failure were evaluated prospectively. The median length of stay was 4 days, and the patients were classified into 2 groups: those with lengths of stay ≤4 days and those with lengths of stay >4 days. Patients with longer lengths of stay had a significantly higher cancer antigen 125 level of 114 U/mL (range, 9-298 U/mL) than did those with a shorter length of stay (19 U/mL; range; 3-68) (P<0.001). The optimal cutoff level of cancer antigen 125 in the prediction of length of stay was >48 U/mL, with a specificity of 95.8% and a sensitivity of 96% (area under the curve, 0.979; 95% confidence interval [CI], 0.953-0.992). In the multivariate logistic regression model, cancer antigen 125 >48 U/mL on admission (odds ratio=4.562; 95% CI, 1.826-11.398;P=0.001), sodium level (P<0.001), creatinine level (P=0.009), and atrial fibrillation (P=0.015) were also associated with a longer length of stay after adjustment for variables found to be statistically significant in univariate analysis and correlated with cancer antigen 125 level. In addition, it appears that in a cohort of patients with acute decompensated heart failure, cancer antigen 125 is independently associated with prolonged length of stay.
authors.forename: Hakki
authors.initials: H
authors.lastname: Kaya
authors.forename: Recep
authors.initials: R
authors.lastname: Kurt
authors.forename: Osman
authors.initials: O
authors.lastname: Beton
authors.forename: Ali
authors.initials: A
authors.lastname: Zorlu
authors.forename: Hasan
authors.initials: H
authors.lastname: Yucel
authors.forename: Hakan
authors.initials: H
authors.lastname: Gunes
authors.forename: Didem
authors.initials: D
authors.lastname: Oguz
authors.forename: Mehmet Birhan
authors.initials: MB
authors.lastname: Yilmaz
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D016009:Chi-Square Distribution; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008565:Membrane Proteins / Q000097:blood*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D013997:Time Factors
chemical_list: D015415:Biomarkers; D018394:CA-125 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins
keywords: CA-125 antigen/blood; diagnostic techniques, cardiovascular; heart failure/complications/diagnosis/etiology/physiopathology; hospitalization/statistics & numerical data; length of stay; logistic models; predictive value of tests; prospective studies; risk assessment/methods; severity of illness index