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Cell‐Free Plasma DNA as a Prognostic Marker in Intensive Treatment Unit Patients
Author(s) -
WIJERATNE S,
BUTT A,
BURNS S,
SHERWOOD K,
BOYD O,
SWAMINATHAN R
Publication year - 2004
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1196/annals.1318.036
Subject(s) - cell free fetal dna , intensive care unit , dna , plasma cell , medicine , chemistry , biology , biochemistry , genetics , pregnancy , fetus , prenatal diagnosis , multiple myeloma
A bstract : Recent evidence suggests that cell‐free plasma DNA has potential use as a prognostic marker in many clinical settings. The aim of the present study was to evaluate the prognostic role of cell‐free plasma DNA in the prediction of clinical outcome in intensive treatment unit (ITU) patients. Cell‐free plasma DNA was measured by real‐time polymerase chain reaction assay for the β‐globin gene and SOFA score, APACHE II score, CRP concentrations, and clinical outcome (duration of stay, ventilation time, and mortality) were noted in 94 patients on admission to the ITU. The median plasma DNA concentration in ITU patients was 5493 GE/mL and this was significantly ( P <0.001) higher than the DNA concentration in healthy subjects (1970 GE/mL). DNA concentration demonstrated a significant correlation with serum C‐reactive protein (CRP) ( r = 0.363 ) concentration and S epsis‐related O rgan F ailure A ssessment (SOFA) ( r = 0.360 ) score ( P <0.001 for both by Pearson correlation) but not with A cute P hysiology A nd C hronic H ealth E valuation (APACHE II) score. Patients on ventilation had significantly higher DNA concentrations compared to nonventilated patients (7362 GE/mL versus 4479 GE/mL; P = 0.004 ). The median DNA concentration in nonsurvivors was 9148 GE/mL, and this was 2.3‐fold greater than that in survivors (3921 GE/ml, P <0.001). ROC analysis of the data indicated a sensitivity of 85% and a specificity of 80% when DNA concentration of 6109 GE/mL was taken as a predictor of death. The data suggest that cell‐free plasma DNA concentration is potentially useful as a prognostic marker in ITU patients.