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Evaluation of the Kinetics of Pancreatic Stone Protein as a Predictor of Ventilator-Associated Pneumonia
BACKGROUND: Ventilator-associated pneumonia (VAP) is a severe condition. Early and adequate antibiotic treatment is the most important strategy for improving prognosis. Pancreatic Stone Protein (PSP) has been described as a biomarker that increases values 3–4 days before the clinical diagnosis of no...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10604889/ https://www.ncbi.nlm.nih.gov/pubmed/37893050 http://dx.doi.org/10.3390/biomedicines11102676 |
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author | Ceccato, Adrian Camprubí-Rimblas, Marta Bos, Lieuwe D. J. Povoa, Pedro Martin-Loeches, Ignacio Forné, Carles Areny-Balagueró, Aina Campaña-Duel, Elena Morales-Quinteros, Luis Quero, Sara Ramirez, Paula Esperatti, Mariano Torres, Antoni Blanch, Lluis Artigas, Antonio |
author_facet | Ceccato, Adrian Camprubí-Rimblas, Marta Bos, Lieuwe D. J. Povoa, Pedro Martin-Loeches, Ignacio Forné, Carles Areny-Balagueró, Aina Campaña-Duel, Elena Morales-Quinteros, Luis Quero, Sara Ramirez, Paula Esperatti, Mariano Torres, Antoni Blanch, Lluis Artigas, Antonio |
author_sort | Ceccato, Adrian |
collection | PubMed |
description | BACKGROUND: Ventilator-associated pneumonia (VAP) is a severe condition. Early and adequate antibiotic treatment is the most important strategy for improving prognosis. Pancreatic Stone Protein (PSP) has been described as a biomarker that increases values 3–4 days before the clinical diagnosis of nosocomial sepsis in different clinical settings. We hypothesized that serial measures of PSP and its kinetics allow for an early diagnosis of VAP. METHODS: The BioVAP study was a prospective observational study designed to evaluate the role of biomarker dynamics in the diagnosis of VAP. To determine the association between repeatedly measured PSP and the risk of VAP, we used joint models for longitudinal and time-to-event data. RESULTS: Of 209 patients, 43 (20.6%) patients developed VAP, with a median time of 4 days. Multivariate joint models with PSP, CRP, and PCT did not show an association between biomarkers and VAP for the daily absolute value, with a hazard ratio (HR) for PSP of 1.01 (95% credible interval: 0.97 to 1.05), for CRP of 1.00 (0.83 to 1.22), and for PCT of 0.95 (0.82 to 1.08). The daily change of biomarkers provided similar results, with an HR for PSP of 1.15 (0.94 to 1.41), for CRP of 0.76 (0.35 to 1.58), and for PCT of 0.77 (0.40 to 1.45). CONCLUSION: Neither absolute PSP values nor PSP kinetics alone nor in combination with other biomarkers were useful in improving the prediction diagnosis accuracy in patients with VAP. Clinical Trial Registration: Registered retrospectively on August 3rd, 2012. NCT02078999. |
format | Online Article Text |
id | pubmed-10604889 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-106048892023-10-28 Evaluation of the Kinetics of Pancreatic Stone Protein as a Predictor of Ventilator-Associated Pneumonia Ceccato, Adrian Camprubí-Rimblas, Marta Bos, Lieuwe D. J. Povoa, Pedro Martin-Loeches, Ignacio Forné, Carles Areny-Balagueró, Aina Campaña-Duel, Elena Morales-Quinteros, Luis Quero, Sara Ramirez, Paula Esperatti, Mariano Torres, Antoni Blanch, Lluis Artigas, Antonio Biomedicines Article BACKGROUND: Ventilator-associated pneumonia (VAP) is a severe condition. Early and adequate antibiotic treatment is the most important strategy for improving prognosis. Pancreatic Stone Protein (PSP) has been described as a biomarker that increases values 3–4 days before the clinical diagnosis of nosocomial sepsis in different clinical settings. We hypothesized that serial measures of PSP and its kinetics allow for an early diagnosis of VAP. METHODS: The BioVAP study was a prospective observational study designed to evaluate the role of biomarker dynamics in the diagnosis of VAP. To determine the association between repeatedly measured PSP and the risk of VAP, we used joint models for longitudinal and time-to-event data. RESULTS: Of 209 patients, 43 (20.6%) patients developed VAP, with a median time of 4 days. Multivariate joint models with PSP, CRP, and PCT did not show an association between biomarkers and VAP for the daily absolute value, with a hazard ratio (HR) for PSP of 1.01 (95% credible interval: 0.97 to 1.05), for CRP of 1.00 (0.83 to 1.22), and for PCT of 0.95 (0.82 to 1.08). The daily change of biomarkers provided similar results, with an HR for PSP of 1.15 (0.94 to 1.41), for CRP of 0.76 (0.35 to 1.58), and for PCT of 0.77 (0.40 to 1.45). CONCLUSION: Neither absolute PSP values nor PSP kinetics alone nor in combination with other biomarkers were useful in improving the prediction diagnosis accuracy in patients with VAP. Clinical Trial Registration: Registered retrospectively on August 3rd, 2012. NCT02078999. MDPI 2023-09-29 /pmc/articles/PMC10604889/ /pubmed/37893050 http://dx.doi.org/10.3390/biomedicines11102676 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ceccato, Adrian Camprubí-Rimblas, Marta Bos, Lieuwe D. J. Povoa, Pedro Martin-Loeches, Ignacio Forné, Carles Areny-Balagueró, Aina Campaña-Duel, Elena Morales-Quinteros, Luis Quero, Sara Ramirez, Paula Esperatti, Mariano Torres, Antoni Blanch, Lluis Artigas, Antonio Evaluation of the Kinetics of Pancreatic Stone Protein as a Predictor of Ventilator-Associated Pneumonia |
title | Evaluation of the Kinetics of Pancreatic Stone Protein as a Predictor of Ventilator-Associated Pneumonia |
title_full | Evaluation of the Kinetics of Pancreatic Stone Protein as a Predictor of Ventilator-Associated Pneumonia |
title_fullStr | Evaluation of the Kinetics of Pancreatic Stone Protein as a Predictor of Ventilator-Associated Pneumonia |
title_full_unstemmed | Evaluation of the Kinetics of Pancreatic Stone Protein as a Predictor of Ventilator-Associated Pneumonia |
title_short | Evaluation of the Kinetics of Pancreatic Stone Protein as a Predictor of Ventilator-Associated Pneumonia |
title_sort | evaluation of the kinetics of pancreatic stone protein as a predictor of ventilator-associated pneumonia |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10604889/ https://www.ncbi.nlm.nih.gov/pubmed/37893050 http://dx.doi.org/10.3390/biomedicines11102676 |
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