Abstract | INTRODUCTION: METHODS: This observational, multicentre, prospective cohort study compared patients at risk for VAP with a control group. Plasma and tracheal aspirate samples were collected. Plasma suPAR levels were measured on the day of diagnosis and 3 days before diagnosis. RESULTS: The study included 24 VAP patients and 19 control patients. The suPAR concentration measured 3 days before diagnosis was significantly increased in VAP patients versus matched samples of control patients (area under the receiver operating characteristic curve (AUC) 0.68, 95% CI 0.52-1.00; p=0.04). Similar results were found on the day of diagnosis (AUC 0.77, 95% CI 0.6-0.93; p=0.01). Plasma suPAR was significantly higher in deceased patients (AUC 0.79, 95% CI 0.57-1.00; p<0.001). Combining suPAR with the Clinical Pulmonary Infection Score, C-reactive protein and/or procalcitonin led to a significantly increased discriminative accuracy for predicting VAP and an increased specificity. CONCLUSIONS: suPAR can be used to diagnose VAP with a fair diagnostic accuracy and has a moderate prognostic accuracy to be used in critically ill intensive care unit patients. Its performance improves when added to other clinically available biomarkers ( C-reactive protein and procalcitonin) or scoring systems (Clinical Pulmonary Infection Score and Sepsis-related Organ Failure Assessment).
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Authors | Pouline M van Oort, Lieuwe D Bos, Pedro Póvoa, Paula Ramirez, Antoni Torres, Antonio Artigas, Marcus J Schultz, Ignacio Martin-Loeches |
Journal | ERJ open research
(ERJ Open Res)
Vol. 5
Issue 1
(Feb 2019)
ISSN: 2312-0541 [Print] England |
PMID | 30918897
(Publication Type: Journal Article)
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