Journal
JOURNAL OF CLINICAL MEDICINE
Volume 11, Issue 12, Pages -Publisher
MDPI
DOI: 10.3390/jcm11123283
Keywords
Humans; Aged; Biomarkers; Receptors; Urokinase Plasminogen Activator; Prognosis; Emergency Service; Hospital; Risk Assessment; Patient Discharge
Categories
Funding
- Department of Emergency Medicine and Services, Helsinki University Hospital (HUS), Haartmaninkatu, PL, HUS
- University of Helsinki
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Emergency department overcrowding is a global issue, and risk stratification for elderly patients is challenging. This study examines the predictive value of suPAR as a biomarker for elderly patients in the ED. Results show that suPAR levels are associated with 30-day mortality and hospital admission, making it a valuable risk predictor.
Emergency department (ED) overcrowding is a global issue setting challenges to all care providers. Elderly patients are frequent visitors of the ED and their risk stratification is demanding due to insufficient assessment methods. A prospective cohort study was conducted to determine the risk-predicting value of a prognostic biomarker, soluble urokinase plasminogen activator receptor (suPAR), in the ED, concentrating on elderly patients. SuPAR levels were determined as part of standard blood sampling of 1858 ED patients. The outcomes were assessed in the group of <75 years (=younger) and >= 75 years (=elderly). The elderly had higher median suPAR levels than the younger (5.4 ng/mL vs. 3.7 ng/mL, p < 0.001). Increasing suPAR levels were associated with higher probability for 30-day mortality and hospital admission in all age groups. SuPAR also predicted 30-day mortality when adjusted to other clinical factors. SuPAR acts successfully as a nonspecific risk predictor for 30-day mortality, independently and with other risk-assessment tools. Low suPAR levels predict positive outcomes and could be used in the discharging process. A cut-off value of 4 ng/mL could be used for all ED patients, 5 ng/mL being a potential alternative in elderly patients.
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