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Open Access 01-03-2019 | Original Scientific Report (including Papers Presented at Surgical Conferences)

Soluble Urokinase Plasminogen Activator Receptor (suPAR) as an Added Predictor to Existing Preoperative Risk Assessments

Authors: Morten Alstrup, Jeppe Meyer, Martin Schultz, Line Jee Hartmann Rasmussen, Lars Simon Rasmussen, Lars Køber, Jakob Lundager Forberg, Jesper Eugen-Olsen, Kasper Iversen

Published in: World Journal of Surgery | Issue 3/2019

Abstract

Background

Risk assessment strategies, such as using the American Society of Anesthesiologists (ASA) physical status classification, attempt to identify surgical high-risk patients. Soluble urokinase plasminogen activator receptor (suPAR) is a biomarker reflecting overall systemic inflammation and immune activation, and it could potentially improve the identification of high-risk surgical patients.

Methods

We included patients acutely admitted to the emergency department who subsequently underwent surgery within 90 days of admission. Patients were stratified into low-risk or high-risk groups, according to ASA classification (ASA_low: ASA I–II; ASA_high: ASA III–VI) and suPAR level, measured at admission (suPAR_high above and suPAR_low below 5.5 ng/ml), respectively. Pre-specified complications were identified in national registries and electronic medical records. The association between ASA classification, suPAR level, CRP and the rate of postoperative complications was analyzed with logistic regression and Cox regression analyses, estimating odds ratios and hazard ratios (HRs).

Results

During 90-day follow-up from surgery, 31 (7.0%) patients died and 158 (35.6%) patients had postoperative complications. After adjusting for age, sex, and ASA classification, the HR for 90-day postoperative mortality was 2.5 (95% CI 1.6–4.0) for every doubling of suPAR level. suPAR was significantly better than CRP at predicting mortality and all complications (P = 0.0036 and P = 0.0041, respectively). Combining ASA classification and suPAR level significantly improved prediction of mortality and the occurrence of a postoperative complication within 90 days after surgery (P < 0.0001).

Conclusion

Measuring suPAR levels in acutely admitted patients may aid in identifying high-risk patients and improve prediction of postoperative complications.

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Title: Soluble Urokinase Plasminogen Activator Receptor (suPAR) as an Added Predictor to Existing Preoperative Risk Assessments
Authors: Morten Alstrup
Jeppe Meyer
Martin Schultz
Line Jee Hartmann Rasmussen
Lars Simon Rasmussen
Lars Køber
Jakob Lundager Forberg
Jesper Eugen-Olsen
Kasper Iversen
Publication date: 01-03-2019
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 3/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-018-4841-1

ACC 2024 Congress

Springer Medicine

Soluble Urokinase Plasminogen Activator Receptor (suPAR) as an Added Predictor to Existing Preoperative Risk Assessments

Abstract

Background

Methods

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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