Low Serum retinol-binding protein-4 levels in acute exacerbations of chronic obstructive pulmonary disease at intensive care unit admission is a predictor of mortality in elderly patientsReportar como inadecuado




Low Serum retinol-binding protein-4 levels in acute exacerbations of chronic obstructive pulmonary disease at intensive care unit admission is a predictor of mortality in elderly patients - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Journal of Inflammation

, 10:31

First Online: 07 October 2013Received: 03 December 2012Accepted: 26 September 2013

Abstract

BackgroundAcute exacerbations of chronic obstructive pulmonary disease AECOPD are thought to be associated with increased mortality in elderly patients. Low retinol-binding protein-4 RBP4 is associated with a high risk of respiratory infections in the general population. Therefore, we hypothesized that low RBP4 levels are associated with an increased risk of AECOPD and can be used as a biomarker for AECOPD in elderly patients.

MethodsEnzyme-linked immunosorbent assays were used to assess RBP4 levels in elderly with AECOPD within the first 24 hours after intensive care unit admission. Forty-six elderly patients with stable COPD in outpatient clinics and 50 healthy elderly persons who had physical examinations as outpatients were controls.

ResultsIn AECOPD patients, RBP4 levels were lower than those in stable COPD patients and healthy controls 59.7 vs 91.2 and 113.6 mg-L, p < 0.001. RBP4 levels were decreased by 30.6% in non-survivors compared with survivors 51.5 vs 74.2 mg-L, p < 0.001. A higher Acute Physiology and Chronic Health Enquiry II APACHE II score and Simplified Acute Physiology score SAPS II were associated with lower RBP4 levels r = −0.692, p = 0.024 and r = −0.670, p = 0.015, respectively. RBP4 was positively correlated with creatinine and body mass index, and negatively correlated with C-reactive protein and Global Initiative for Chronic Obstructive Lung Disease stage. Multivariate logistic regression showed that RBP4 was an independent mortality predictor of AECOPD odds ratio: 0.926, p = 0.007. Analysis of the area under the receiver operating characteristic AUC curve showed that RBP4 showed good discrimination AUC: 0.88; 95% confidence interval: 0.78–0.94; p = 0.008 in predicting mortality. RBP4 improved the prognostic accuracy of mortality for the APACHE II and SAPS II scores.

ConclusionsSerum RBP4 levels are significantly reduced in elderly AECOPD patients. RBP4 might be a good predictive biomarker for mortality in elderly AECOPD patients in the intensive care unit.

KeywordsAcute exacerbations of chronic obstructive pulmonary disease Retinol-binding protein-4 Predictor Elderly Intensive care unit Electronic supplementary materialThe online version of this article doi:10.1186-1476-9255-10-31 contains supplementary material, which is available to authorized users.

Download fulltext PDF



Autor: Qihui Jin - Yueliang Chen - Yufeng Lou - Xiaojun He

Fuente: https://link.springer.com/







Documentos relacionados