Department of Intensive Care Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands.
Department of Intensive Care Medicine and Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, the Netherlands.
J Crit Care. 2023 Dec;78:154383. doi: 10.1016/j.jcrc.2023.154383. Epub 2023 Jul 21.
Biomarkers independently associated with outcome of intensive care unit (ICU) patients can improve risk assessment. The cytosolic protease dipeptidyl-peptidase 3 (DPP3) is released into the circulation upon cell necrosis. We aimed to investigate the prognostic properties of cDPP3 in a mixed-admission ICU cohort.
Prospective observational study in 650 adult ICU patients. cDPP3 concentrations were measured at ICU admission (day 1), and on days 2 and 3.
cDPP3 concentrations on days 1 and 2, but not on day 3 were associated with 28-day mortality; HR 1.36 (95%CI 1.01-1.83, p = 0.043) and HR 1.49 (95%CI 1.16-1.93, p = 0.002) for days 1 and 2, respectively. cDPP3 was also associated with acute kidney injury (AKI), with OR's of 1.31 (95%CI 1.05-1.64, p = 0.016), 1.87 (95%CI 1.51-2.34, p < 0.001) and 1.49 (95%CI 1.16-1.92, p = 0.002) for measurements performed on days 1, 2, and 3, respectively. In multivariate analyses including SOFA or APACHE-II scores, cDPP3 assessed at day 2 of admission remained an independent predictor of mortality and all-stage AKI.
In a mixed-ICU cohort, cDPP3 concentrations after start of initial treatment were independently associated with both mortality and development of AKI. Therefore, measurement of cDPP3 can improve risk-stratification provided by established disease severity scores.
与重症监护病房（ICU）患者结局独立相关的生物标志物可改善风险评估。细胞质蛋白酶二肽基肽酶 3（DPP3）在细胞坏死时释放到循环中。我们旨在研究混合 ICU 队列中 cDPP3 的预后特性。
对 650 名成年 ICU 患者进行前瞻性观察性研究。在 ICU 入院时（第 1 天）以及第 2 天和第 3 天测量 cDPP3 浓度。
第 1 天和第 2 天的 cDPP3 浓度，但第 3 天的浓度与 28 天死亡率相关；第 1 天和第 2 天的 HR 分别为 1.36（95%CI 1.01-1.83，p=0.043）和 1.49（95%CI 1.16-1.93，p=0.002）。cDPP3 还与急性肾损伤（AKI）相关，第 1、2 和 3 天的 OR 分别为 1.31（95%CI 1.05-1.64，p=0.016）、1.87（95%CI 1.51-2.34，p<0.001）和 1.49（95%CI 1.16-1.92，p=0.002）。在包括 SOFA 或 APACHE-II 评分的多变量分析中，入院第 2 天评估的 cDPP3 仍然是死亡率和全阶段 AKI 的独立预测因子。
在混合 ICU 队列中，初始治疗开始后 cDPP3 浓度与死亡率和 AKI 的发生独立相关。因此，cDPP3 的测量可以改善由既定疾病严重程度评分提供的风险分层。
