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Endostatin predicts mortality in patients with acute dyspnea - a cohort study of patients seeking care in emergency departments.
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2019 (English)In: Clinical Biochemistry, ISSN 0009-9120, E-ISSN 1873-2933, Vol. 75, article id S0009-9120(19)30514-4Article in journal (Refereed) Published
Abstract [en]

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 %.

Place, publisher, year, edition, pages
2019. Vol. 75, article id S0009-9120(19)30514-4
Keywords [en]
Acute dyspnea, Cardiovascular, Emergency department, Endostatin, Epidemiology, METTS-A, Mortality
National Category
Clinical Medicine
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-31097DOI: 10.1016/j.clinbiochem.2019.10.004ISI: 000503447200006PubMedID: 31672650Scopus ID: 2-s2.0-85075435893OAI: oai:DiVA.org:du-31097DiVA, id: diva2:1371070
Available from: 2019-11-19 Created: 2019-11-19 Last updated: 2020-03-19Bibliographically approved

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Ärnlöv, Johan

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