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Open Access 01-12-2021 | Biomarkers | Research

Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients

Authors: Shigeto Ishikawa, Yuto Teshima, Hiroki Otsubo, Takashi Shimazui, Taka-aki Nakada, Osamu Takasu, Kenichi Matsuda, Junichi Sasaki, Masakazu Nabeta, Takeshi Moriguchi, Takayuki Shibusawa, Toshihiko Mayumi, Shigeto Oda

Published in: BMC Emergency Medicine | Issue 1/2021

Abstract

Background

Shock and organ damage occur in critically ill patients in the emergency department because of biological responses to invasion, and cytokines play an important role in their development. It is important to predict early multiple organ dysfunction (MOD) because it is useful in predicting patient outcomes and selecting treatment strategies. This study examined the accuracy of biomarkers, including interleukin (IL)-6, in predicting early MOD in critically ill patients compared with that of quick sequential organ failure assessment (qSOFA).

Methods

This was a multicenter observational sub-study. Five universities from 2016 to 2018. Data of adult patients with systemic inflammatory response syndrome who presented to the emergency department or were admitted to the intensive care unit were prospectively evaluated. qSOFA score and each biomarker (IL-6, IL-8, IL-10, tumor necrosis factor-α, C-reactive protein, and procalcitonin [PCT]) level were assessed on Days 0, 1, and 2. The primary outcome was set as MOD on Day 2, and the area under the curve (AUC) was analyzed to evaluate qSOFA scores and biomarker levels.

Results

Of 199 patients, 38 were excluded and 161 were included. Patients with MOD on Day 2 had significantly higher qSOFA, SOFA, and Acute Physiology and Chronic Health Evaluation II scores and a trend toward worse prognosis, including mortality. The AUC for qSOFA score (Day 0) that predicted MOD (Day 2) was 0.728 (95% confidence interval [CI]: 0.651–0.794). IL-6 (Day 1) showed the highest AUC among all biomarkers (0.790 [95% CI: 0.711–852]). The combination of qSOFA (Day 0) and IL-6 (Day 1) showed improved prediction accuracy (0.842 [95% CI: 0.771–0.893]). The combination model using qSOFA (Day 1) and IL-6 (Day 1) also showed a higher AUC (0.868 [95% CI: 0.799–0.915]). The combination model of IL-8 and PCT also showed a significant improvement in AUC.

Conclusions

The addition of IL-6, IL-8 and PCT to qSOFA scores improved the accuracy of early MOD prediction.

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Title: Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients
Authors: Shigeto Ishikawa
Yuto Teshima
Hiroki Otsubo
Takashi Shimazui
Taka-aki Nakada
Osamu Takasu
Kenichi Matsuda
Junichi Sasaki
Masakazu Nabeta
Takeshi Moriguchi
Takayuki Shibusawa
Toshihiko Mayumi
Shigeto Oda
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Biomarkers
Published in: BMC Emergency Medicine / Issue 1/2021
Electronic ISSN: 1471-227X
DOI: https://doi.org/10.1186/s12873-021-00534-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Risk prediction of biomarkers for early multiple organ dysfunction in critically ill patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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