Abstract
BackgroundPrognostic abilities of medical parameters, which are scoring systems, measurements and biomarkers, are important for stratifying critically ill patients. Indocyanine green plasma disappearance (ICG-PDR) is an established clinical tool for the assessment of liver perfusion and function. Copeptin, MR-proANP and pro-ADM are biomarkers whose prognostic value is still unclear. The goal of this prospective study was to evaluate ICG-PDR, copeptin, MR-proANP and pro-ADM to predict prolonged length of stay (pLOS) in the ICU.MethodsThis study was conducted as a prospective single center study including 110 consecutively admitted ICU patients. Primary endpoint was prolonged length of stay (pLOS) in the ICU, defined as more than three days of stay there.ResultsROC analysis showed an AUC of 0.73 for ICG-PDR, 0.70 for SAPS II, 0.65 for MR-proANP, 0.64 for pro-ADM and 0.54 for copeptin for pLOS in the ICU.ConclusionsThe prediction of pLOS in the ICU might be better by means of ICG-PDR than with the new biomarkers copeptin, MR-proANP or pro-ADM. Nevertheless, there is more need for research to evaluate whether ICG-PDR is an overall prognostic marker for pLOS.Trial registration(ClinicalTrials.gov number, NCT01126554).
Highlights
Prognostic abilities of medical parameters, which are scoring systems, measurements and biomarkers, are important for stratifying critically ill patients
The goal of this study was to investigate the accuracy of Indocyanine green plasma disappearance (ICG-PDR), SAPS Simplified Acute Physiology Score (II), copeptin, MR-proANP, proADM and other established biomarkers for prediction of prolonged length of stay (pLOS) in the ICU
The aim was the comparison of the prognostic value of the ICG-liver test and SAPS II score on the one hand with new biomarkers, and on the other hand to established biomarkers (bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (AP), International Normalized Ratio (INR), hemoglobin, white blood cell (WBC) count, activated partial thromboplastin time, dDimer, cystatin C, C-reactive protein (CRP), procalcitonin (PCT), IL-6, the B-type natriuretic peptide (NT-proBNP) Primary endpoint was prolonged length of stay in the ICU, represented by more than three days
Summary
Prognostic abilities of medical parameters, which are scoring systems, measurements and biomarkers, are important for stratifying critically ill patients. Indocyanine green plasma disappearance (ICG-PDR) is an established clinical tool for the assessment of liver perfusion and function. MR-proANP and pro-ADM are biomarkers whose prognostic value is still unclear The goal of this prospective study was to evaluate ICG-PDR, copeptin, MR-proANP and pro-ADM to predict prolonged length of stay (pLOS) in the ICU. The prognostic abilities of medical parameters, which are scoring systems, measurements and biomarkers, are important for stratifying critically ill patients [1] to optimize resources and further investigation in this area is warranted. Indocyanine green plasma disappearance rate (ICGPDR) is closely correlated to hepatic function due to its hepatic metabolization. The capability of ICGPDR to predict LOS in the ICU remains elusive
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