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Pentraxin‐3 level at admission is a strong predictor of short‐term mortality in a community‐based hospital setting
Author(s) -
BastrupBirk S.,
MuntheFog L.,
Skjoedt M.O.,
Ma Y. J.,
Nielsen H.,
Køber L.,
Nielsen O. W.,
Iversen K.,
Garred P.
Publication year - 2015
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/joim.12294
Subject(s) - medicine , hazard ratio , confidence interval , percentile , cohort , ptx3 , proportional hazards model , renal function , cohort study , gastroenterology , statistics , mathematics , inflammation
Background The pattern recognition molecule pentraxin‐3 ( PTX 3) is a novel potential marker of prognosis, as elevated levels are associated with both disease severity and mortality in patients with a wide range of conditions. However, the usefulness of PTX 3 as a prognostic biomarker in a general hospital setting is unknown. Patients and methods The study cohort consisted of 1326 unselected, consecutive patients (age >40 years) admitted to a community hospital in Copenhagen, Denmark. Patients were followed until death or for a median of 11.5 years after admission. The main outcome measure was all‐cause mortality. Serum samples collected from patients at admission and from 192 healthy control subjects were quantified for PTX 3 level by enzyme‐linked immunosorbent assay. Results PTX3 was elevated in patients (median 3.7 ng mL −1 , range 0.5–209.8) compared with healthy nonhospitalized subjects (median 3.5 ng mL −1 , range 0.0–8.3; P = 0.0003). Elevated PTX3 levels, defined as above the 95th percentile of the concentration in healthy subjects, were associated with increased overall mortality during the study ( P < 0.0001). This increase in mortality was greatest in the short term, with an unadjusted hazard ratio (HR) of 6.4 [95% confidence interval (CI) 3.8–11.0] at 28 days after admission, compared to 1.7 (95% CI 1.4–2.0) at the end of follow‐up. These results were still significant after adjustment for age, gender and glomerular filtration rate: adjusted HR of 5.0 (95% CI 2.9–8.8) and 1.4 (95% CI 1.2–1.8), respectively. Conclusion These results suggest that PTX 3 could be a widely applicable marker of short‐term mortality in hospitalized patients and may be useful in the initial risk stratification.