The predictive value of modified soluble urokinase plasminogen activator receptor (suPAR) with National Early Warning Score (NEWS) for mortality in emergency elderly patients in Japan: a prospective pilot study.

Abstract

The aim of this study is to evaluate the ability of soluble urokinase plasminogen activator receptor (suPAR) and modified suPAR with National Early Warning Score (NEWS) for detecting mortality in elderly emergency patients who are older than 70 years. This is a secondary analysis of our previous study, which was a single-center prospective pilot study, carried out for 21 months in the emergency department of a secondary emergency institution in Japan. This study was carried out between September 16, 2020, and June 21, 2022. The study included all patients without trauma aged 70 years or older who presented to the emergency department. Discrimination was assessed by plotting the receiver-operating characteristic curve and calculating the area under the receiver-operating characteristic curve (AUC). During the study period, 47 eligible older patients were included, among which 8 (17.0%) patients died. The median suPAR was significantly lower in the survivor's group than in the nonsurvivor's group (P < 0.01). For suPAR, the AUC for the prediction of mortality was 0.805 (95% confidence interval 0.633-0.949, P < 0.001). The AUC of modified suPAR with NEWS for mortality was higher than that of suPAR [0.865 (95% confidence interval 0.747-0.958, P < 0.001)]. Our single-center study has demonstrated the high utility of modified suPAR with NEWS as a predictive tool of mortality in elderly emergency patients. Evidence from multicenter studies is needed for introducing modified suPAR with NEWS in the emergency department setting.