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Early sclerostin assessment in frail elderly patients with sepsis: insights on short- and long-term mortality prediction
Unmet needs challenge clinical management of sepsis especially concerning patient profiling, enhancing recovery, and long-term sequelae. Here, we preliminarily focused on sclerostin (SOST) as a candidate biomarker to encompass such a broad range of clinical needs related to sepsis. Seventy-three sep...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10412666/ https://www.ncbi.nlm.nih.gov/pubmed/36943596 http://dx.doi.org/10.1007/s11739-023-03223-w |
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author | Tirandi, Amedeo Arboscello, Eleonora Ministrini, Stefano Liberale, Luca Bonaventura, Aldo Vecchié, Alessandra Bertolotto, Maria Giacobbe, Daniele Roberto Castellani, Luca Mirabella, Michele Minetti, Silvia Bassetti, Matteo Montecucco, Fabrizio Carbone, Federico |
author_facet | Tirandi, Amedeo Arboscello, Eleonora Ministrini, Stefano Liberale, Luca Bonaventura, Aldo Vecchié, Alessandra Bertolotto, Maria Giacobbe, Daniele Roberto Castellani, Luca Mirabella, Michele Minetti, Silvia Bassetti, Matteo Montecucco, Fabrizio Carbone, Federico |
author_sort | Tirandi, Amedeo |
collection | PubMed |
description | Unmet needs challenge clinical management of sepsis especially concerning patient profiling, enhancing recovery, and long-term sequelae. Here, we preliminarily focused on sclerostin (SOST) as a candidate biomarker to encompass such a broad range of clinical needs related to sepsis. Seventy-three septic patients were enrolled at internal medicine wards between January 2017 and December 2019 in this pilot study. Clinical examination and blood sample analyses were collected at enrollment and after 7 and 14 days. SOST levels were assessed on serum by ELISA. Thirty-day mortality was set as primary outcome. In-hospital and long-term mortality (2.5 years of median follow-up) were assessed as secondary outcomes. Patients were frail, elderly, and heterogeneous in terms of comorbidity burden. SOST levels were associated with age, cardiovascular comorbidities, and time to early death (30 days). When regression models were built, SOST displayed a high predictive value toward 30-day mortality (OR 13.459 with 95% CI 1.226–148.017) with ever better performance than validated scoring scales for critical ill patients. Such a predictive value of SOST was further confirmed for in-hospital (HR 10.089 with 95% CI 1.375–74.013) and long-term mortality (HR 5.061 with 95% CI 1.379–18.570). SOST levels generally decreased over 7 to 14 days after enrollment (p for trend < 0.001). The degree of this variation further predicted long-term mortality (HR for Δ SOST T0–day 14: 1.006 with 95% CI 1.001–1.011). Our results suggest a role for SOST in both short- and long-time prediction of worse outcome in septic elderly admitted to internal medicine wards. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11739-023-03223-w. |
format | Online Article Text |
id | pubmed-10412666 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-104126662023-08-11 Early sclerostin assessment in frail elderly patients with sepsis: insights on short- and long-term mortality prediction Tirandi, Amedeo Arboscello, Eleonora Ministrini, Stefano Liberale, Luca Bonaventura, Aldo Vecchié, Alessandra Bertolotto, Maria Giacobbe, Daniele Roberto Castellani, Luca Mirabella, Michele Minetti, Silvia Bassetti, Matteo Montecucco, Fabrizio Carbone, Federico Intern Emerg Med EM - Original Unmet needs challenge clinical management of sepsis especially concerning patient profiling, enhancing recovery, and long-term sequelae. Here, we preliminarily focused on sclerostin (SOST) as a candidate biomarker to encompass such a broad range of clinical needs related to sepsis. Seventy-three septic patients were enrolled at internal medicine wards between January 2017 and December 2019 in this pilot study. Clinical examination and blood sample analyses were collected at enrollment and after 7 and 14 days. SOST levels were assessed on serum by ELISA. Thirty-day mortality was set as primary outcome. In-hospital and long-term mortality (2.5 years of median follow-up) were assessed as secondary outcomes. Patients were frail, elderly, and heterogeneous in terms of comorbidity burden. SOST levels were associated with age, cardiovascular comorbidities, and time to early death (30 days). When regression models were built, SOST displayed a high predictive value toward 30-day mortality (OR 13.459 with 95% CI 1.226–148.017) with ever better performance than validated scoring scales for critical ill patients. Such a predictive value of SOST was further confirmed for in-hospital (HR 10.089 with 95% CI 1.375–74.013) and long-term mortality (HR 5.061 with 95% CI 1.379–18.570). SOST levels generally decreased over 7 to 14 days after enrollment (p for trend < 0.001). The degree of this variation further predicted long-term mortality (HR for Δ SOST T0–day 14: 1.006 with 95% CI 1.001–1.011). Our results suggest a role for SOST in both short- and long-time prediction of worse outcome in septic elderly admitted to internal medicine wards. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11739-023-03223-w. Springer International Publishing 2023-03-21 2023 /pmc/articles/PMC10412666/ /pubmed/36943596 http://dx.doi.org/10.1007/s11739-023-03223-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | EM - Original Tirandi, Amedeo Arboscello, Eleonora Ministrini, Stefano Liberale, Luca Bonaventura, Aldo Vecchié, Alessandra Bertolotto, Maria Giacobbe, Daniele Roberto Castellani, Luca Mirabella, Michele Minetti, Silvia Bassetti, Matteo Montecucco, Fabrizio Carbone, Federico Early sclerostin assessment in frail elderly patients with sepsis: insights on short- and long-term mortality prediction |
title | Early sclerostin assessment in frail elderly patients with sepsis: insights on short- and long-term mortality prediction |
title_full | Early sclerostin assessment in frail elderly patients with sepsis: insights on short- and long-term mortality prediction |
title_fullStr | Early sclerostin assessment in frail elderly patients with sepsis: insights on short- and long-term mortality prediction |
title_full_unstemmed | Early sclerostin assessment in frail elderly patients with sepsis: insights on short- and long-term mortality prediction |
title_short | Early sclerostin assessment in frail elderly patients with sepsis: insights on short- and long-term mortality prediction |
title_sort | early sclerostin assessment in frail elderly patients with sepsis: insights on short- and long-term mortality prediction |
topic | EM - Original |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10412666/ https://www.ncbi.nlm.nih.gov/pubmed/36943596 http://dx.doi.org/10.1007/s11739-023-03223-w |
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