suPAR cut-offs for stratification of low, medium, and high-risk acute medical patients in the emergency department
Dublin Core
Title
suPAR cut-offs for stratification of low, medium, and high-risk acute medical patients in the emergency department
Subject
suPAR, Laboratory marker, Emergency department, Mortality
Description
Background: Soluble urokinase plasminogen activator receptor (suPAR) levels have previously been associated with
readmission and mortality in acute medical patients in the ED. However, no specific cut-offs for suPAR have been
tested in this population.
Methods: Prospective observational study of consecutively included acute medical patients. Follow-up of mortality
and readmission was carried out for 30- and 90 days stratified into baseline suPAR < 4, 4–6 and > 6 ng/ml. suPAR
levels were measured using suPARnostic® Turbilatex assay on a Cobas c501 (Roche Diagnostics Ltd) analyser.
Results: A total of 1747 acute medical patients in the ED were included. Median age was 70 (IQR: 57–79) and
51.4% were men. Adjusted linear regression analysis showed that suPAR, independently of age, sex and C-reactive
protein levels, predicted 30- and 90-day mortality (Odds ratio for doubling in suPAR 1.96 (95% confidence intervals:
1.42–2.70) Among patients with suPAR below 4 ng/ml (N = 804, 46.0%), 8 (1.0%) died within 90-day follow-up,
resulting in a negative predictive value of 99.0% and a sensitivity of 94.6%. Altogether 514 (29.4%) patients had
suPAR of 4–6 ng/ml, of whom 43 (8.4%) died during 90-day follow-up. Among patients with suPAR above 6 ng/ml
(N = 429, 24.6%), 87 patients (20.3%) died within 90-day follow-up, resulting in a positive predictive value of 20.1%
and a specificity of 78.7%.
Conclusions: suPAR cut-offs of below 4, between 4 and 6 and above 6 ng/ml can identify acute medical patients
who have low, medium or high risk of 30- and 90-day mortality. The turbidimetric assay provides suPAR results
within 30 min that may aid in the decision of discharge or admission of acute medical patients.
readmission and mortality in acute medical patients in the ED. However, no specific cut-offs for suPAR have been
tested in this population.
Methods: Prospective observational study of consecutively included acute medical patients. Follow-up of mortality
and readmission was carried out for 30- and 90 days stratified into baseline suPAR < 4, 4–6 and > 6 ng/ml. suPAR
levels were measured using suPARnostic® Turbilatex assay on a Cobas c501 (Roche Diagnostics Ltd) analyser.
Results: A total of 1747 acute medical patients in the ED were included. Median age was 70 (IQR: 57–79) and
51.4% were men. Adjusted linear regression analysis showed that suPAR, independently of age, sex and C-reactive
protein levels, predicted 30- and 90-day mortality (Odds ratio for doubling in suPAR 1.96 (95% confidence intervals:
1.42–2.70) Among patients with suPAR below 4 ng/ml (N = 804, 46.0%), 8 (1.0%) died within 90-day follow-up,
resulting in a negative predictive value of 99.0% and a sensitivity of 94.6%. Altogether 514 (29.4%) patients had
suPAR of 4–6 ng/ml, of whom 43 (8.4%) died during 90-day follow-up. Among patients with suPAR above 6 ng/ml
(N = 429, 24.6%), 87 patients (20.3%) died within 90-day follow-up, resulting in a positive predictive value of 20.1%
and a specificity of 78.7%.
Conclusions: suPAR cut-offs of below 4, between 4 and 6 and above 6 ng/ml can identify acute medical patients
who have low, medium or high risk of 30- and 90-day mortality. The turbidimetric assay provides suPAR results
within 30 min that may aid in the decision of discharge or admission of acute medical patients.
Creator
Seppälä Santeri, Andersen Andreas Peter, Nyyssönen Kristiina, Eugen-Olsen Jesper and Hyppölä Harri
Publisher
BMC Emergency Medicine
Date
(2021) 21:149
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Seppälä Santeri, Andersen Andreas Peter, Nyyssönen Kristiina, Eugen-Olsen Jesper and Hyppölä Harri, “suPAR cut-offs for stratification of low, medium, and high-risk acute medical patients in the emergency department,” Repository Horizon University Indonesia, accessed February 5, 2025, https://repository.horizon.ac.id/items/show/3915.