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Transthyretin at Admission and Over Time as a Marker for Clinical Outcomes in Critically Ill Trauma Patients: A Prospective Single-Center Study

BACKGROUND: Transthyretin (TTR) has been described as a predictor for outcomes in medical and surgical patients. However, the association of TTR on admission and over time on outcomes has not yet been prospectively assessed in trauma patients. METHODS: This is a prospective observational study inclu...

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Autores principales: Haltmeier, Tobias, Inaba, Kenji, Durso, Joseph, Khan, Moazzam, Siboni, Stefano, Cheng, Vincent, Schnüriger, Beat, Benjamin, Elizabeth, Demetriades, Demetrios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7222866/
https://www.ncbi.nlm.nih.gov/pubmed/31637508
http://dx.doi.org/10.1007/s00268-019-05140-6
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author Haltmeier, Tobias
Inaba, Kenji
Durso, Joseph
Khan, Moazzam
Siboni, Stefano
Cheng, Vincent
Schnüriger, Beat
Benjamin, Elizabeth
Demetriades, Demetrios
author_facet Haltmeier, Tobias
Inaba, Kenji
Durso, Joseph
Khan, Moazzam
Siboni, Stefano
Cheng, Vincent
Schnüriger, Beat
Benjamin, Elizabeth
Demetriades, Demetrios
author_sort Haltmeier, Tobias
collection PubMed
description BACKGROUND: Transthyretin (TTR) has been described as a predictor for outcomes in medical and surgical patients. However, the association of TTR on admission and over time on outcomes has not yet been prospectively assessed in trauma patients. METHODS: This is a prospective observational study including trauma patients admitted to the intensive care unit (ICU) of a large Level I trauma center 05/2014–05/2015. TTR levels at ICU admission and all subsequent values over time were recorded. Patients were observed for 28 days or until hospital discharge. The association of outcomes and TTR levels at admission and over time was assessed using multivariable regression and generalized estimating equation (GEE) analysis, respectively. RESULTS: A total of 237 patients with TTR obtained at admission were included, 69 of whom had repeated TTR measurements. Median age was 40.0 years and median ISS 16.0; 83.1% were male. Below-normal TTR levels at admission (41.8%) were independently associated with higher in-hospital mortality (p = 0.042), more infectious complications (p = 0.032), longer total hospital length of stay (LOS) (p = 0.013), and ICU LOS (p = 0.041). Higher TTR levels over time were independently associated with lower in-hospital mortality (p = 0.015), fewer infections complications (p = 0.028), shorter total hospital and ICU LOS (both p < 0.001), and fewer ventilator days (0.004). CONCLUSIONS: In critically ill trauma patients, below-normal TTR levels at admission were independently associated with worse outcomes and higher TTR levels over time with better outcomes, including lower in-hospital mortality, less infectious complications, shorter total hospital and ICU LOS, and fewer ventilator days. Based on these results, TTR may be considered as a prognostic marker in this patient population.
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spelling pubmed-72228662020-05-15 Transthyretin at Admission and Over Time as a Marker for Clinical Outcomes in Critically Ill Trauma Patients: A Prospective Single-Center Study Haltmeier, Tobias Inaba, Kenji Durso, Joseph Khan, Moazzam Siboni, Stefano Cheng, Vincent Schnüriger, Beat Benjamin, Elizabeth Demetriades, Demetrios World J Surg Original Scientific Report BACKGROUND: Transthyretin (TTR) has been described as a predictor for outcomes in medical and surgical patients. However, the association of TTR on admission and over time on outcomes has not yet been prospectively assessed in trauma patients. METHODS: This is a prospective observational study including trauma patients admitted to the intensive care unit (ICU) of a large Level I trauma center 05/2014–05/2015. TTR levels at ICU admission and all subsequent values over time were recorded. Patients were observed for 28 days or until hospital discharge. The association of outcomes and TTR levels at admission and over time was assessed using multivariable regression and generalized estimating equation (GEE) analysis, respectively. RESULTS: A total of 237 patients with TTR obtained at admission were included, 69 of whom had repeated TTR measurements. Median age was 40.0 years and median ISS 16.0; 83.1% were male. Below-normal TTR levels at admission (41.8%) were independently associated with higher in-hospital mortality (p = 0.042), more infectious complications (p = 0.032), longer total hospital length of stay (LOS) (p = 0.013), and ICU LOS (p = 0.041). Higher TTR levels over time were independently associated with lower in-hospital mortality (p = 0.015), fewer infections complications (p = 0.028), shorter total hospital and ICU LOS (both p < 0.001), and fewer ventilator days (0.004). CONCLUSIONS: In critically ill trauma patients, below-normal TTR levels at admission were independently associated with worse outcomes and higher TTR levels over time with better outcomes, including lower in-hospital mortality, less infectious complications, shorter total hospital and ICU LOS, and fewer ventilator days. Based on these results, TTR may be considered as a prognostic marker in this patient population. Springer International Publishing 2019-10-21 2020 /pmc/articles/PMC7222866/ /pubmed/31637508 http://dx.doi.org/10.1007/s00268-019-05140-6 Text en © Société Internationale de Chirurgie 2019 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Scientific Report
Haltmeier, Tobias
Inaba, Kenji
Durso, Joseph
Khan, Moazzam
Siboni, Stefano
Cheng, Vincent
Schnüriger, Beat
Benjamin, Elizabeth
Demetriades, Demetrios
Transthyretin at Admission and Over Time as a Marker for Clinical Outcomes in Critically Ill Trauma Patients: A Prospective Single-Center Study
title Transthyretin at Admission and Over Time as a Marker for Clinical Outcomes in Critically Ill Trauma Patients: A Prospective Single-Center Study
title_full Transthyretin at Admission and Over Time as a Marker for Clinical Outcomes in Critically Ill Trauma Patients: A Prospective Single-Center Study
title_fullStr Transthyretin at Admission and Over Time as a Marker for Clinical Outcomes in Critically Ill Trauma Patients: A Prospective Single-Center Study
title_full_unstemmed Transthyretin at Admission and Over Time as a Marker for Clinical Outcomes in Critically Ill Trauma Patients: A Prospective Single-Center Study
title_short Transthyretin at Admission and Over Time as a Marker for Clinical Outcomes in Critically Ill Trauma Patients: A Prospective Single-Center Study
title_sort transthyretin at admission and over time as a marker for clinical outcomes in critically ill trauma patients: a prospective single-center study
topic Original Scientific Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7222866/
https://www.ncbi.nlm.nih.gov/pubmed/31637508
http://dx.doi.org/10.1007/s00268-019-05140-6
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