Associations between biomarkers of multimorbidity burden and mortality risk among patients with acute dyspnea
Wessman, Torgny LU ; Tofik, Rafid LU ; Ruge, Thoralph and Melander, Olle LU
(2022)
In Internal and Emergency Medicine
17(2).
p.559-567
- Abstract
The patients’ burden of comorbidities is a cornerstone in risk assessment, clinical management and follow-up. The aim of this study was to evaluate if biomarkers associated with comorbidity burden can predict outcome in acute dyspnea patients. We included 774 patients with dyspnea admitted to an emergency department and measured 80 cardiovascular protein biomarkers in serum collected at admission. The number of comorbidities for each patient were added, and a multimorbidity score was created. Eleven of the 80 biomarkers were independently associated with the multimorbidity score and their standardized and weighted values were summed into a biomarker score of multimorbidities. The biomarker score and the multimorbidity score, expressed... (More)
The patients’ burden of comorbidities is a cornerstone in risk assessment, clinical management and follow-up. The aim of this study was to evaluate if biomarkers associated with comorbidity burden can predict outcome in acute dyspnea patients. We included 774 patients with dyspnea admitted to an emergency department and measured 80 cardiovascular protein biomarkers in serum collected at admission. The number of comorbidities for each patient were added, and a multimorbidity score was created. Eleven of the 80 biomarkers were independently associated with the multimorbidity score and their standardized and weighted values were summed into a biomarker score of multimorbidities. The biomarker score and the multimorbidity score, expressed per standard deviation increment, respectively, were related to all-cause mortality using Cox Proportional Hazards Model. During long-term follow-up (2.4 ± 1.5 years) 45% of the patients died and during short-term follow-up (90 days) 12% died. Through long-term follow-up, in fully adjusted models, the HR (95% CI) for mortality concerning the biomarker score was 1.59 (95% CI 1348–1871) and 1.18 (95% CI 1035–1346) for the multimorbidity score. For short-term follow-up, in the fully adjusted model, the biomarker score was strongly related to 90-day mortality (HR 1.98, 95% CI 1428–2743), whereas the multimorbidity score was not significant. Our main findings suggest that the biomarker score is superior to the multimorbidity score in predicting long and short-term mortality. Measurement of the biomarker score may serve as a biological fingerprint of the multimorbidity score at the emergency department and, therefore, be helpful for risk prediction, treatment decisions and need of follow-up both in hospital and after discharge from the emergency department.
(Less)
- author
- Wessman, Torgny
LU
; Tofik, Rafid
LU
; Ruge, Thoralph
and Melander, Olle
LU
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Acute dyspnea, Biomarker, Comorbidity, Emergency department, METTS, Multimorbidity, Risk factors
- in
- Internal and Emergency Medicine
- volume
- 17
- issue
- 2
- pages
- 559 - 567
- publisher
- Springer
- external identifiers
-
- pmid:34417729
- scopus:85113179376
- ISSN
- 1828-0447
- DOI
- 10.1007/s11739-021-02825-6
- project
- MOVING FROM BIOMARKERS TO MECHANISM ORIENTED PREVENTION OF CARDIOMETABOLIC DISEASE
- language
- English
- LU publication?
- yes
- id
- 50331862-655e-46e2-8d56-7397aa68a6da
- date added to LUP
- 2021-09-06 12:00:57
- date last changed
- 2024-07-13 18:07:19
@article{50331862-655e-46e2-8d56-7397aa68a6da,
abstract = {{<p>The patients’ burden of comorbidities is a cornerstone in risk assessment, clinical management and follow-up. The aim of this study was to evaluate if biomarkers associated with comorbidity burden can predict outcome in acute dyspnea patients. We included 774 patients with dyspnea admitted to an emergency department and measured 80 cardiovascular protein biomarkers in serum collected at admission. The number of comorbidities for each patient were added, and a multimorbidity score was created. Eleven of the 80 biomarkers were independently associated with the multimorbidity score and their standardized and weighted values were summed into a biomarker score of multimorbidities. The biomarker score and the multimorbidity score, expressed per standard deviation increment, respectively, were related to all-cause mortality using Cox Proportional Hazards Model. During long-term follow-up (2.4 ± 1.5 years) 45% of the patients died and during short-term follow-up (90 days) 12% died. Through long-term follow-up, in fully adjusted models, the HR (95% CI) for mortality concerning the biomarker score was 1.59 (95% CI 1348–1871) and 1.18 (95% CI 1035–1346) for the multimorbidity score. For short-term follow-up, in the fully adjusted model, the biomarker score was strongly related to 90-day mortality (HR 1.98, 95% CI 1428–2743), whereas the multimorbidity score was not significant. Our main findings suggest that the biomarker score is superior to the multimorbidity score in predicting long and short-term mortality. Measurement of the biomarker score may serve as a biological fingerprint of the multimorbidity score at the emergency department and, therefore, be helpful for risk prediction, treatment decisions and need of follow-up both in hospital and after discharge from the emergency department.</p>}},
author = {{Wessman, Torgny and Tofik, Rafid and Ruge, Thoralph and Melander, Olle}},
issn = {{1828-0447}},
keywords = {{Acute dyspnea; Biomarker; Comorbidity; Emergency department; METTS; Multimorbidity; Risk factors}},
language = {{eng}},
number = {{2}},
pages = {{559--567}},
publisher = {{Springer}},
series = {{Internal and Emergency Medicine}},
title = {{Associations between biomarkers of multimorbidity burden and mortality risk among patients with acute dyspnea}},
url = {{http://dx.doi.org/10.1007/s11739-021-02825-6}},
doi = {{10.1007/s11739-021-02825-6}},
volume = {{17}},
year = {{2022}},
}