Abstract
BackgroundThe progression of biomarkers over time is considered an indicator of disease progression and helps in the early detection of disease, thereby reducing disease-related mortality. Their ability to predict outcomes has been evaluated using conventional cross-sectional methods. This study investigated the prognostic performance of biomarkers over time.MethodsPatients aged > 18 years admitted to the burn intensive care unit within 24 h of a burn incident were enrolled. Information regarding longitudinal biomarkers, including white blood cells; platelet count; lactate, creatinine, and total bilirubin levels; and prothrombin time (PT), were retrieved from a clinical database. Time-dependent receiver operating characteristic curves using cumulative/dynamic and incident/dynamic (ID) approaches were used to evaluate prognostic performance.ResultsOverall, 2259 patients were included and divided into survival and non-survival groups. By determining the area under the curve using the ID approach, platelets showed the highest c-index [0.930 (0.919–0.941)] across all time points. Conversely, the c-index of PT and creatinine levels were 0.862 (0.843–0.881) and 0.828 (0.809–0.848), respectively.ConclusionsPlatelet count was the best prognostic marker, followed by PT. Total bilirubin and creatinine levels also showed good prognostic ability. Although lactate was a strong predictor, it showed relatively poor prognostic performance in burns patients.
Highlights
The progression of biomarkers over time is considered an indicator of disease progression and helps in the early detection of disease, thereby reducing disease-related mortality
From February 2007 to December 2018, patients aged > 18 years who were admitted at the burn intensive care unit (BICU) of Hangang Sacred Heart Hospital, Hallym University Medical Center within 24 h of the burn incident were included in this retrospective study; all the patients underwent acute fluid resuscitation during the first 3 days after the burn
Baseline characteristics of the survivors and non-survivors In total, 2259 patients were included in this retrospective study; among them, 1786 patients were allocated to the survival group and 473 to the non-survival group; the overall mortality was 20.9%
Summary
The progression of biomarkers over time is considered an indicator of disease progression and helps in the early detection of disease, thereby reducing disease-related mortality. Their ability to predict outcomes has been evaluated using conventional cross-sectional methods. The disease state of an individual changes over time; prognostic information, such as updated biomarkers recorded during routine measurements, changes, possibly affecting the performance of decisionmaking tools. Statistical methods have been developed to generalize these traditional cross-sectional accuracy concepts for determining the time-varying characteristics of disease states [3]. The ability of biomarkers to predict outcomes has been evaluated using conventional, cross-sectional methods [4]. In this study, we investigated the prognostic potential of biomarkers routinely used in clinical practice over time and compared whether different biomarkers have varying prognostic accuracies at different times during treatment
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
