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Cell-free DNA increase over first 48 hours in emergency intensive care unit predicts fatal outcome in patients with shock

OBJECTIVE: To investigate whether circulating cell-free (cf)-DNA levels are a useful biomarker for survival in patients with shock in the emergency intensive care unit (EICU). METHODS: This prospective observational study enrolled patients admitted to the EICU diagnosed with shock. Blood cf-DNA leve...

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Detalles Bibliográficos
Autores principales: Xia, Dun Ling, Zhang, Hong, Luo, Qing Li, Zhang, A Fang, Zhu, Li Xin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5536549/
https://www.ncbi.nlm.nih.gov/pubmed/27388470
http://dx.doi.org/10.1177/0300060516650785
Descripción
Sumario:OBJECTIVE: To investigate whether circulating cell-free (cf)-DNA levels are a useful biomarker for survival in patients with shock in the emergency intensive care unit (EICU). METHODS: This prospective observational study enrolled patients admitted to the EICU diagnosed with shock. Blood cf-DNA levels were analysed on admission, and after 24 and 48 h. As a measure of circulating cf-DNA, copy number of the β-globin gene in plasma was assessed using quantitative real-time polymerase chain reaction. RESULTS: Circulating cf-DNA levels were higher at hospital admission and after 24 h in EICU patients with shock who died than in those who recovered. Change in cf-DNA levels over the first 48 h in critical care was independently associated with 28-day mortality. The critical cut-off value for cf-DNA change over 48 h in predicting 28-day mortality was +16.12% (sensitivity 68.9%, specificity 89.7%). CONCLUSIONS: Increased circulating cf-DNA levels in EICU patients with shock are associated with risk of death and measuring cf-DNA change over 48 h improves risk prediction. The present study suggests that cf-DNA may serve as a viable plasma biomarker of mortality risk in EICU patients with shock.