Soluble urokinase plasminogen activator receptor (suPAR) in acute care: a strong marker of disease presence and severity, readmission and mortality. A retrospective cohort study

Line Jee Hartmann Rasmussen; Steen Ladelund; Thomas Huneck Haupt; Gertrude Ellekilde; Jørgen Hjelm Poulsen; Kasper Iversen; Jesper Eugen-Olsen; Ove Andersen

doi:10.1136/emermed-2015-205444

Soluble urokinase plasminogen activator receptor (suPAR) in acute care: a strong marker of disease presence and severity, readmission and mortality. A retrospective cohort study

Line Jee Hartmann Rasmussen, Steen Ladelund, Thomas Huneck Haupt, Gertrude Ellekilde, Jørgen Hjelm Poulsen, Kasper Iversen, Jesper Eugen-Olsen, Ove Andersen

Institut for Klinisk Medicin

39 Citationer (Scopus)

Abstract

OBJECTIVE: Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker associated with presence and progression of disease and with increased risk of mortality. We aimed to evaluate the unspecific biomarker suPAR as a prognostic marker in patients admitted to acute care.

METHODS: This registry-based retrospective cohort study included 4343 consecutively admitted patients from the Acute Medical Unit at a large Danish university hospital. Time to readmission and death were analysed by multiple Cox regression. Results were reported as HRs for 30-day and 90-day follow-up.

RESULTS: During 30-day follow-up, 782 patients (18.0%) were readmitted and 224 patients (5.2%) died. Comparing 30-day readmission and mortality between patients in the highest and lowest suPAR quartiles yielded HRs of 2.11 (95% CI 1.70 to 2.62) and 4.11 (95% CI 2.46 to 6.85), respectively, when adjusting for age, sex, Charlson score and C reactive protein. Area under the curve for receiver operating characteristics curve analysis of suPAR for 30-day mortality was 0.84 (95% CI 0.81 to 0.86). Furthermore, in the entire cohort, women had slightly higher suPAR compared with men, and suPAR was associated with age, admission time, admission to intensive care unit and Charlson score.

CONCLUSIONS: In this large unselected population of acute medical patients, suPAR is strongly associated with disease severity, readmission and mortality after adjusting for all other risk factors, indicating that suPAR adds information to established prognostic indicators. While patients with low suPAR levels have low risk of readmission and mortality, patients with high suPAR levels have a high risk of adverse events.

Originalsprog	Engelsk
Tidsskrift	Emergency Medicine Journal
Vol/bind	33
Udgave nummer	11
Sider (fra-til)	769-775
Antal sider	7
ISSN	1472-0205
DOI	https://doi.org/10.1136/emermed-2015-205444
Status	Udgivet - 1 nov. 2016

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10.1136/emermed-2015-205444

Citationsformater

Rasmussen, L. J. H., Ladelund, S., Haupt, T. H., Ellekilde, G., Poulsen, J. H., Iversen, K., Eugen-Olsen, J., & Andersen, O. (2016). Soluble urokinase plasminogen activator receptor (suPAR) in acute care: a strong marker of disease presence and severity, readmission and mortality. A retrospective cohort study. Emergency Medicine Journal, 33(11), 769-775. https://doi.org/10.1136/emermed-2015-205444

Soluble urokinase plasminogen activator receptor (suPAR) in acute care : a strong marker of disease presence and severity, readmission and mortality. A retrospective cohort study. / Rasmussen, Line Jee Hartmann; Ladelund, Steen; Haupt, Thomas Huneck et al.

I: Emergency Medicine Journal, Bind 33, Nr. 11, 01.11.2016, s. 769-775.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Rasmussen, LJH, Ladelund, S, Haupt, TH, Ellekilde, G, Poulsen, JH, Iversen, K, Eugen-Olsen, J & Andersen, O 2016, 'Soluble urokinase plasminogen activator receptor (suPAR) in acute care: a strong marker of disease presence and severity, readmission and mortality. A retrospective cohort study', Emergency Medicine Journal, bind 33, nr. 11, s. 769-775. https://doi.org/10.1136/emermed-2015-205444

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title = "Soluble urokinase plasminogen activator receptor (suPAR) in acute care: a strong marker of disease presence and severity, readmission and mortality. A retrospective cohort study",

abstract = "OBJECTIVE: Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker associated with presence and progression of disease and with increased risk of mortality. We aimed to evaluate the unspecific biomarker suPAR as a prognostic marker in patients admitted to acute care.METHODS: This registry-based retrospective cohort study included 4343 consecutively admitted patients from the Acute Medical Unit at a large Danish university hospital. Time to readmission and death were analysed by multiple Cox regression. Results were reported as HRs for 30-day and 90-day follow-up.RESULTS: During 30-day follow-up, 782 patients (18.0%) were readmitted and 224 patients (5.2%) died. Comparing 30-day readmission and mortality between patients in the highest and lowest suPAR quartiles yielded HRs of 2.11 (95% CI 1.70 to 2.62) and 4.11 (95% CI 2.46 to 6.85), respectively, when adjusting for age, sex, Charlson score and C reactive protein. Area under the curve for receiver operating characteristics curve analysis of suPAR for 30-day mortality was 0.84 (95% CI 0.81 to 0.86). Furthermore, in the entire cohort, women had slightly higher suPAR compared with men, and suPAR was associated with age, admission time, admission to intensive care unit and Charlson score.CONCLUSIONS: In this large unselected population of acute medical patients, suPAR is strongly associated with disease severity, readmission and mortality after adjusting for all other risk factors, indicating that suPAR adds information to established prognostic indicators. While patients with low suPAR levels have low risk of readmission and mortality, patients with high suPAR levels have a high risk of adverse events.",

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author = "Rasmussen, {Line Jee Hartmann} and Steen Ladelund and Haupt, {Thomas Huneck} and Gertrude Ellekilde and Poulsen, {J{\o}rgen Hjelm} and Kasper Iversen and Jesper Eugen-Olsen and Ove Andersen",

note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.",

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doi = "10.1136/emermed-2015-205444",

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T1 - Soluble urokinase plasminogen activator receptor (suPAR) in acute care

T2 - a strong marker of disease presence and severity, readmission and mortality. A retrospective cohort study

AU - Rasmussen, Line Jee Hartmann

AU - Ladelund, Steen

AU - Haupt, Thomas Huneck

AU - Ellekilde, Gertrude

AU - Poulsen, Jørgen Hjelm

AU - Iversen, Kasper

AU - Eugen-Olsen, Jesper

AU - Andersen, Ove

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

PY - 2016/11/1

Y1 - 2016/11/1

N2 - OBJECTIVE: Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker associated with presence and progression of disease and with increased risk of mortality. We aimed to evaluate the unspecific biomarker suPAR as a prognostic marker in patients admitted to acute care.METHODS: This registry-based retrospective cohort study included 4343 consecutively admitted patients from the Acute Medical Unit at a large Danish university hospital. Time to readmission and death were analysed by multiple Cox regression. Results were reported as HRs for 30-day and 90-day follow-up.RESULTS: During 30-day follow-up, 782 patients (18.0%) were readmitted and 224 patients (5.2%) died. Comparing 30-day readmission and mortality between patients in the highest and lowest suPAR quartiles yielded HRs of 2.11 (95% CI 1.70 to 2.62) and 4.11 (95% CI 2.46 to 6.85), respectively, when adjusting for age, sex, Charlson score and C reactive protein. Area under the curve for receiver operating characteristics curve analysis of suPAR for 30-day mortality was 0.84 (95% CI 0.81 to 0.86). Furthermore, in the entire cohort, women had slightly higher suPAR compared with men, and suPAR was associated with age, admission time, admission to intensive care unit and Charlson score.CONCLUSIONS: In this large unselected population of acute medical patients, suPAR is strongly associated with disease severity, readmission and mortality after adjusting for all other risk factors, indicating that suPAR adds information to established prognostic indicators. While patients with low suPAR levels have low risk of readmission and mortality, patients with high suPAR levels have a high risk of adverse events.

AB - OBJECTIVE: Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker associated with presence and progression of disease and with increased risk of mortality. We aimed to evaluate the unspecific biomarker suPAR as a prognostic marker in patients admitted to acute care.METHODS: This registry-based retrospective cohort study included 4343 consecutively admitted patients from the Acute Medical Unit at a large Danish university hospital. Time to readmission and death were analysed by multiple Cox regression. Results were reported as HRs for 30-day and 90-day follow-up.RESULTS: During 30-day follow-up, 782 patients (18.0%) were readmitted and 224 patients (5.2%) died. Comparing 30-day readmission and mortality between patients in the highest and lowest suPAR quartiles yielded HRs of 2.11 (95% CI 1.70 to 2.62) and 4.11 (95% CI 2.46 to 6.85), respectively, when adjusting for age, sex, Charlson score and C reactive protein. Area under the curve for receiver operating characteristics curve analysis of suPAR for 30-day mortality was 0.84 (95% CI 0.81 to 0.86). Furthermore, in the entire cohort, women had slightly higher suPAR compared with men, and suPAR was associated with age, admission time, admission to intensive care unit and Charlson score.CONCLUSIONS: In this large unselected population of acute medical patients, suPAR is strongly associated with disease severity, readmission and mortality after adjusting for all other risk factors, indicating that suPAR adds information to established prognostic indicators. While patients with low suPAR levels have low risk of readmission and mortality, patients with high suPAR levels have a high risk of adverse events.

KW - Journal Article

U2 - 10.1136/emermed-2015-205444

DO - 10.1136/emermed-2015-205444

M3 - Journal article

C2 - 27590986

SN - 1472-0205

VL - 33

SP - 769

EP - 775

JO - Emergency Medicine Journal

JF - Emergency Medicine Journal

IS - 11

ER -

Soluble urokinase plasminogen activator receptor (suPAR) in acute care: a strong marker of disease presence and severity, readmission and mortality. A retrospective cohort study

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