Elevated Serum Tenascin-C Predicts Mortality in Critically Ill Patients With Multiple Organ Dysfunction
Background: Multiple organ dysfunction is a complex and lethal clinical feature with heterogeneous causes and is usually characterized by tissue injury of multiple organs. Tenascin-C (TNC) is a matricellular protein that is rarely expressed in most of the adult tissues, but re-induced following inju...
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.759273/full |
| _version_ | 1828955425904525312 |
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| author | Yunyu Xu Nanyang Li Jiamin Gao Da Shang Min Zhang Xiaoyi Mao Ruiying Chen Jianming Zheng Ying Shan Mingquan Chen Qionghong Xie Chuan-Ming Hao |
| author_facet | Yunyu Xu Nanyang Li Jiamin Gao Da Shang Min Zhang Xiaoyi Mao Ruiying Chen Jianming Zheng Ying Shan Mingquan Chen Qionghong Xie Chuan-Ming Hao |
| author_sort | Yunyu Xu |
| collection | DOAJ |
| description | Background: Multiple organ dysfunction is a complex and lethal clinical feature with heterogeneous causes and is usually characterized by tissue injury of multiple organs. Tenascin-C (TNC) is a matricellular protein that is rarely expressed in most of the adult tissues, but re-induced following injury. This study aimed to evaluate serum TNC in predicting mortality in critically ill patients with multiple organ dysfunction.Methods: Adult critically ill patients with at least two organs dysfunction and an increase of Sequential Organ Failure Assess (SOFA) score ≥ 2 points within 7 days were prospectively enrolled into two independent cohorts. The emergency (derivation) cohort was a consecutive series and the patients were from Emergency Department. The inpatient (validation) cohort was a convenience series and the patients were from medical wards. Their serum samples at the first 24 h after enrollment were collected and subjected to TNC measurement using ELISA. The association between serum TNC level and 28-day all-cause mortality was investigated, and then the predictive value of serum TNC was analyzed.Results: A total of 110 patients with a median age of 64 years (53, 73) were enrolled in the emergency cohort. Compared to the survivors, serum TNC in the non-survivors was significantly higher (467.7 vs. 197.5 ng/ml, p < 0.001). Multivariate logistic regression analysis revealed that the association between serum TNC and 28-day mortality was independent of sepsis or critical illness scores such as SOFA, Acute Physiology and Chronic Health Evaluation (APACHE II), and Simplified Acute Physiology Score (SAPS II), respectively (p < 0.001 for each). The area under receiver operating characteristic curve of serum TNC for predicting mortality was 0.803 (0.717–0.888) (p < 0.001), similar with SOFA 0.808 (0.725–0.891), APACHE II 0.762 (0.667–0.857), and SAPS II 0.779 (0.685–0.872). The optimal cut-off value of serum TNC was 298.2 ng/ml. Kaplan–Meier analysis showed that the survival of patients with serum TNC ≥ 300 ng/ml was significantly worse than that of patients with serum TNC < 300 ng/ml. This result was validated in the inpatient cohort. The sensitivity and specificity of serum TNC ≥ 300 ng/ml for predicting mortality were 74.3 and 74.7% in the emergency cohort, and 63.0 and 70.1% in the inpatient cohort, respectively.Conclusion: Serum TNC was associated with mortality in critically ill patients with multiple organ dysfunction, and would be used as a prognostic tool for predicting mortality in this population. |
| first_indexed | 2024-12-14T07:51:08Z |
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| id | doaj.art-8efe9b13e6f84955b925fbc5b4a670e7 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-14T07:51:08Z |
| publishDate | 2021-11-01 |
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| spelling | doaj.art-8efe9b13e6f84955b925fbc5b4a670e72022-12-21T23:10:43ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-11-01810.3389/fmed.2021.759273759273Elevated Serum Tenascin-C Predicts Mortality in Critically Ill Patients With Multiple Organ DysfunctionYunyu Xu0Nanyang Li1Jiamin Gao2Da Shang3Min Zhang4Xiaoyi Mao5Ruiying Chen6Jianming Zheng7Ying Shan8Mingquan Chen9Qionghong Xie10Chuan-Ming Hao11Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency, Huashan Hospital, Fudan University, Shanghai, ChinaDivision of Nephrology, Huashan Hospital, Fudan University, Shanghai, ChinaDivision of Nephrology, Huashan Hospital, Fudan University, Shanghai, ChinaDivision of Nephrology, Huashan Hospital, Fudan University, Shanghai, ChinaDivision of Nephrology, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency, Huashan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency, Huashan Hospital, Fudan University, Shanghai, ChinaDivision of Nephrology, Huashan Hospital, Fudan University, Shanghai, ChinaDivision of Nephrology, Huashan Hospital, Fudan University, Shanghai, ChinaBackground: Multiple organ dysfunction is a complex and lethal clinical feature with heterogeneous causes and is usually characterized by tissue injury of multiple organs. Tenascin-C (TNC) is a matricellular protein that is rarely expressed in most of the adult tissues, but re-induced following injury. This study aimed to evaluate serum TNC in predicting mortality in critically ill patients with multiple organ dysfunction.Methods: Adult critically ill patients with at least two organs dysfunction and an increase of Sequential Organ Failure Assess (SOFA) score ≥ 2 points within 7 days were prospectively enrolled into two independent cohorts. The emergency (derivation) cohort was a consecutive series and the patients were from Emergency Department. The inpatient (validation) cohort was a convenience series and the patients were from medical wards. Their serum samples at the first 24 h after enrollment were collected and subjected to TNC measurement using ELISA. The association between serum TNC level and 28-day all-cause mortality was investigated, and then the predictive value of serum TNC was analyzed.Results: A total of 110 patients with a median age of 64 years (53, 73) were enrolled in the emergency cohort. Compared to the survivors, serum TNC in the non-survivors was significantly higher (467.7 vs. 197.5 ng/ml, p < 0.001). Multivariate logistic regression analysis revealed that the association between serum TNC and 28-day mortality was independent of sepsis or critical illness scores such as SOFA, Acute Physiology and Chronic Health Evaluation (APACHE II), and Simplified Acute Physiology Score (SAPS II), respectively (p < 0.001 for each). The area under receiver operating characteristic curve of serum TNC for predicting mortality was 0.803 (0.717–0.888) (p < 0.001), similar with SOFA 0.808 (0.725–0.891), APACHE II 0.762 (0.667–0.857), and SAPS II 0.779 (0.685–0.872). The optimal cut-off value of serum TNC was 298.2 ng/ml. Kaplan–Meier analysis showed that the survival of patients with serum TNC ≥ 300 ng/ml was significantly worse than that of patients with serum TNC < 300 ng/ml. This result was validated in the inpatient cohort. The sensitivity and specificity of serum TNC ≥ 300 ng/ml for predicting mortality were 74.3 and 74.7% in the emergency cohort, and 63.0 and 70.1% in the inpatient cohort, respectively.Conclusion: Serum TNC was associated with mortality in critically ill patients with multiple organ dysfunction, and would be used as a prognostic tool for predicting mortality in this population.https://www.frontiersin.org/articles/10.3389/fmed.2021.759273/fulltenascin-Ccritically ill patientsmultiple organ dysfunction (MODS)mortalitybiomarker |
| spellingShingle | Yunyu Xu Nanyang Li Jiamin Gao Da Shang Min Zhang Xiaoyi Mao Ruiying Chen Jianming Zheng Ying Shan Mingquan Chen Qionghong Xie Chuan-Ming Hao Elevated Serum Tenascin-C Predicts Mortality in Critically Ill Patients With Multiple Organ Dysfunction Frontiers in Medicine tenascin-C critically ill patients multiple organ dysfunction (MODS) mortality biomarker |
| title | Elevated Serum Tenascin-C Predicts Mortality in Critically Ill Patients With Multiple Organ Dysfunction |
| title_full | Elevated Serum Tenascin-C Predicts Mortality in Critically Ill Patients With Multiple Organ Dysfunction |
| title_fullStr | Elevated Serum Tenascin-C Predicts Mortality in Critically Ill Patients With Multiple Organ Dysfunction |
| title_full_unstemmed | Elevated Serum Tenascin-C Predicts Mortality in Critically Ill Patients With Multiple Organ Dysfunction |
| title_short | Elevated Serum Tenascin-C Predicts Mortality in Critically Ill Patients With Multiple Organ Dysfunction |
| title_sort | elevated serum tenascin c predicts mortality in critically ill patients with multiple organ dysfunction |
| topic | tenascin-C critically ill patients multiple organ dysfunction (MODS) mortality biomarker |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.759273/full |
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