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Circulating dipeptidyl peptidase 3 on intensive care unit admission is a predictor of organ dysfunction and mortality

Frigyesi, Attila LU ; Lengquist, Maria LU orcid ; Spångfors, Martin LU orcid ; Annborn, Martin LU ; Cronberg, Tobias LU ; Nielsen, Niklas LU ; Levin, Helena LU and Friberg, Hans LU (2021) In Journal of Intensive Care 9(1).
Abstract

BACKGROUND: Our aim was to investigate the prognostic potential of circulating dipeptidyl peptidase 3 (cDPP3) to predict mortality and development of organ dysfunction in a mixed intensive care unit (ICU) population, and for this reason, we analysed prospectively collected admission blood samples from adult ICU patients at four Swedish hospitals. Blood samples were stored in a biobank for later batch analysis. The association of cDPP3 levels with 30-day mortality and Sequential Organ Failure Assessment (SOFA) scores on day two was investigated before and after adjustment for the simplified acute physiology score III (SAPS-3), using multivariable (ordinal) logistic regression. The predictive power of cDPP3 was assessed using the area... (More)

BACKGROUND: Our aim was to investigate the prognostic potential of circulating dipeptidyl peptidase 3 (cDPP3) to predict mortality and development of organ dysfunction in a mixed intensive care unit (ICU) population, and for this reason, we analysed prospectively collected admission blood samples from adult ICU patients at four Swedish hospitals. Blood samples were stored in a biobank for later batch analysis. The association of cDPP3 levels with 30-day mortality and Sequential Organ Failure Assessment (SOFA) scores on day two was investigated before and after adjustment for the simplified acute physiology score III (SAPS-3), using multivariable (ordinal) logistic regression. The predictive power of cDPP3 was assessed using the area under the receiver operating characteristic curve (AUROC).

RESULTS: Of 1978 included consecutive patients in 1 year (2016), 632 fulfilled the sepsis 3-criteria, 190 were admitted after cardiac arrest, and 157 because of trauma. Admission cDPP3 was independently (of SAPS-3) associated with 30-day mortality with odds ratios of 1.45 (95% confidence interval (CI) 1.28-1.64) in the entire ICU population, 1.30 (95% CI 1.08-1.57) in the sepsis subgroup and 2.28 (95% CI 1.50-3.62) in cardiac arrest. For trauma, there was no clear association. Circulating DPP3 alone was a moderate predictor of 30-day mortality with AUROCs of 0.68, 0.62, and 0.72 in the entire group, the sepsis subgroup, and the cardiac arrest subgroup, respectively. By adding cDPP3 to SAPS-3, AUROC improved for the entire group, the sepsis subgroup, and the cardiac arrest subgroup (p = 0.023).

CONCLUSION: Circulating DPP3 on admission is a SAPS-3 independent prognostic factor of day-two organ dysfunction and 30-day mortality in a mixed ICU population and needs further evaluation.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Intensive Care
volume
9
issue
1
article number
52
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85113294413
  • pmid:34429159
ISSN
2052-0492
DOI
10.1186/s40560-021-00561-9
project
SweCrit, a critical care biobank
language
English
LU publication?
yes
id
162611b1-df76-496e-a9fb-df79e6cbc8b2
date added to LUP
2021-08-30 10:21:57
date last changed
2025-02-09 15:15:02
@article{162611b1-df76-496e-a9fb-df79e6cbc8b2,
  abstract     = {{<p>BACKGROUND: Our aim was to investigate the prognostic potential of circulating dipeptidyl peptidase 3 (cDPP3) to predict mortality and development of organ dysfunction in a mixed intensive care unit (ICU) population, and for this reason, we analysed prospectively collected admission blood samples from adult ICU patients at four Swedish hospitals. Blood samples were stored in a biobank for later batch analysis. The association of cDPP3 levels with 30-day mortality and Sequential Organ Failure Assessment (SOFA) scores on day two was investigated before and after adjustment for the simplified acute physiology score III (SAPS-3), using multivariable (ordinal) logistic regression. The predictive power of cDPP3 was assessed using the area under the receiver operating characteristic curve (AUROC).</p><p>RESULTS: Of 1978 included consecutive patients in 1 year (2016), 632 fulfilled the sepsis 3-criteria, 190 were admitted after cardiac arrest, and 157 because of trauma. Admission cDPP3 was independently (of SAPS-3) associated with 30-day mortality with odds ratios of 1.45 (95% confidence interval (CI) 1.28-1.64) in the entire ICU population, 1.30 (95% CI 1.08-1.57) in the sepsis subgroup and 2.28 (95% CI 1.50-3.62) in cardiac arrest. For trauma, there was no clear association. Circulating DPP3 alone was a moderate predictor of 30-day mortality with AUROCs of 0.68, 0.62, and 0.72 in the entire group, the sepsis subgroup, and the cardiac arrest subgroup, respectively. By adding cDPP3 to SAPS-3, AUROC improved for the entire group, the sepsis subgroup, and the cardiac arrest subgroup (p = 0.023).</p><p>CONCLUSION: Circulating DPP3 on admission is a SAPS-3 independent prognostic factor of day-two organ dysfunction and 30-day mortality in a mixed ICU population and needs further evaluation.</p>}},
  author       = {{Frigyesi, Attila and Lengquist, Maria and Spångfors, Martin and Annborn, Martin and Cronberg, Tobias and Nielsen, Niklas and Levin, Helena and Friberg, Hans}},
  issn         = {{2052-0492}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Journal of Intensive Care}},
  title        = {{Circulating dipeptidyl peptidase 3 on intensive care unit admission is a predictor of organ dysfunction and mortality}},
  url          = {{http://dx.doi.org/10.1186/s40560-021-00561-9}},
  doi          = {{10.1186/s40560-021-00561-9}},
  volume       = {{9}},
  year         = {{2021}},
}