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Endostatin predicts mortality in patients with acute dyspnea – A cohort study of patients seeking care in emergency departments

Carlsson, A. C. ; Wessman, T. LU ; Larsson, A. ; Leijonberg, G. ; Tofik, R. LU ; Ärnlöv, J. ; Melander, O. LU and Ruge, T. LU (2020) In Clinical Biochemistry 75. p.35-39
Abstract

Background: Increased levels of circulating endostatin predicts cardiovascular morbidity and impaired kidney function in the general population. The utility of endostatin as a risk marker for mortality in the emergency department (ED) has not been reported. Aim: Our main aim was to study the association between plasma endostatin and 90-day mortality in an unselected cohort of patients admitted to the ED for acute dyspnea. Design Circulating endostatin was analyzed in plasma from 1710 adults and related to 90-day mortality in Cox proportional hazard models adjusted for age, sex, body mass index, oxygen saturation, respiratory rate, body temperature, C-reactive protein, lactate, creatinine and medical priority according to the Medical... (More)

Background: Increased levels of circulating endostatin predicts cardiovascular morbidity and impaired kidney function in the general population. The utility of endostatin as a risk marker for mortality in the emergency department (ED) has not been reported. Aim: Our main aim was to study the association between plasma endostatin and 90-day mortality in an unselected cohort of patients admitted to the ED for acute dyspnea. Design Circulating endostatin was analyzed in plasma from 1710 adults and related to 90-day mortality in Cox proportional hazard models adjusted for age, sex, body mass index, oxygen saturation, respiratory rate, body temperature, C-reactive protein, lactate, creatinine and medical priority according to the Medical Emergency Triage and Treatment System–Adult score (METTS-A). The predictive value of endostatin for mortality was evaluated with receiver operating characteristic (ROC) analysis and compared with the clinical triage scoring system and age. Results: Each one standard deviation increment of endostatin was associated with a HR of 2.12 (95% CI 1.31–3.44 p < 0.01) for 90-day mortality after full adjustment. Levels of endostatin were significantly increased in the group of patients with highest METTS-A (p < 0.001). When tested for the outcome 90-day mortality, the area under the ROC curve (AUC) was 0.616 for METTS-A, 0.701 for endostatin, 0.708 for METTS -A and age and 0.738 for METTS-A, age and levels of endostatin. Conclusions: In an unselected cohort of patients admitted to the ED with acute dyspnea, endostatin had a string association to 90-day mortality and improved prediction of 90-day mortality in the ED beyond the clinical triage scoring system and age with 3%.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute dyspnea, Cardiovascular, Emergency department, Endostatin, Epidemiology, METTS-A, Mortality
in
Clinical Biochemistry
volume
75
pages
5 pages
publisher
Elsevier
external identifiers
  • scopus:85075435893
  • pmid:31672650
ISSN
0009-9120
DOI
10.1016/j.clinbiochem.2019.10.004
language
English
LU publication?
yes
id
1433826b-d921-4fd4-841d-312c5263ae83
date added to LUP
2019-12-09 09:03:07
date last changed
2020-01-14 11:34:04
@article{1433826b-d921-4fd4-841d-312c5263ae83,
  abstract     = {<p>Background: Increased levels of circulating endostatin predicts cardiovascular morbidity and impaired kidney function in the general population. The utility of endostatin as a risk marker for mortality in the emergency department (ED) has not been reported. Aim: Our main aim was to study the association between plasma endostatin and 90-day mortality in an unselected cohort of patients admitted to the ED for acute dyspnea. Design Circulating endostatin was analyzed in plasma from 1710 adults and related to 90-day mortality in Cox proportional hazard models adjusted for age, sex, body mass index, oxygen saturation, respiratory rate, body temperature, C-reactive protein, lactate, creatinine and medical priority according to the Medical Emergency Triage and Treatment System–Adult score (METTS-A). The predictive value of endostatin for mortality was evaluated with receiver operating characteristic (ROC) analysis and compared with the clinical triage scoring system and age. Results: Each one standard deviation increment of endostatin was associated with a HR of 2.12 (95% CI 1.31–3.44 p &lt; 0.01) for 90-day mortality after full adjustment. Levels of endostatin were significantly increased in the group of patients with highest METTS-A (p &lt; 0.001). When tested for the outcome 90-day mortality, the area under the ROC curve (AUC) was 0.616 for METTS-A, 0.701 for endostatin, 0.708 for METTS -A and age and 0.738 for METTS-A, age and levels of endostatin. Conclusions: In an unselected cohort of patients admitted to the ED with acute dyspnea, endostatin had a string association to 90-day mortality and improved prediction of 90-day mortality in the ED beyond the clinical triage scoring system and age with 3%.</p>},
  author       = {Carlsson, A. C. and Wessman, T. and Larsson, A. and Leijonberg, G. and Tofik, R. and Ärnlöv, J. and Melander, O. and Ruge, T.},
  issn         = {0009-9120},
  language     = {eng},
  pages        = {35--39},
  publisher    = {Elsevier},
  series       = {Clinical Biochemistry},
  title        = {Endostatin predicts mortality in patients with acute dyspnea – A cohort study of patients seeking care in emergency departments},
  url          = {http://dx.doi.org/10.1016/j.clinbiochem.2019.10.004},
  doi          = {10.1016/j.clinbiochem.2019.10.004},
  volume       = {75},
  year         = {2020},
}