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01-05-2012 | Original

Prognostic value of chromogranin A in severe sepsis: data from the FINNSEPSIS study

Authors: Helge Røsjø, Ståle Nygård, Kirsi-Maija Kaukonen, Sari Karlsson, Mats Stridsberg, Esko Ruokonen, Ville Pettilä, Torbjørn Omland, FINNSEPSIS Study Group

Published in: Intensive Care Medicine | Issue 5/2012

Abstract

Purpose

To assess the prognostic information of chromogranin A (CgA), a marker associated with adrenergic tone and myocardial function, in patients with severe sepsis.

Methods

CgA levels were measured at the time of study inclusion and 72 h later in 232 patients with severe sepsis recruited from 24 ICUs in Finland (FINNSEPSIS study).

Results

Sixty-five patients (28 %) died during the index hospitalization. CgA levels at inclusion and after 72 h correlated with several established indices of risk in sepsis. Patients who died during the hospitalization had higher baseline CgA levels than hospital survivors: 14.0 (Q1–3, 7.4–27.4) versus 9.1 (5.9–15.8) nmol/l, P = 0.002, and after 72 h: 16.2 (9.0–31.1) versus 9.8 (6.0–18.0) nmol/l, P = 0.001. Prior cardiovascular disease (P = 0.04) and cardiovascular SOFA levels on day 3 (P = 0.03) were associated with higher CgA levels after 72 h by linear regression. CgA levels on study inclusion and after 72 h were independently associated with hospital mortality by logistic regression: OR (logarithmically transformed CgA levels) 1.95 (95 % CI 1.01–3.77), P = 0.046 and OR 2.03 (95 % CI 1.18–3.49), P = 0.01, respectively. The prognostic accuracy was comparable for CgA measurements and SAPS II score, and the addition of CgA measurements to the SAPS II score improved risk stratification of the patients as assessed by the category-free net reclassification index. A CgA level >6.6 nmol/l on study inclusion was associated with septic shock during the hospitalization.

Conclusion

CgA levels measured during hospitalization for severe sepsis are associated with cardiovascular dysfunction and may provide additional prognostic information in patients with severe sepsis.

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Title: Prognostic value of chromogranin A in severe sepsis: data from the FINNSEPSIS study
Authors: Helge Røsjø
Ståle Nygård
Kirsi-Maija Kaukonen
Sari Karlsson
Mats Stridsberg
Esko Ruokonen
Ville Pettilä
Torbjørn Omland
FINNSEPSIS Study Group
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 5/2012
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-012-2546-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prognostic value of chromogranin A in severe sepsis: data from the FINNSEPSIS study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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