Title |
Plasma surfactant protein-D as a diagnostic biomarker for acute respiratory distress syndrome: validation in US and Korean cohorts
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Published in |
BMC Pulmonary Medicine, December 2017
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DOI | 10.1186/s12890-017-0532-1 |
Pubmed ID | |
Authors |
Jinkyeong Park, Maria Pabon, Augustine M. K. Choi, Ilias I. Siempos, Laura E. Fredenburgh, Rebecca M. Baron, Kyeongman Jeon, Chi Ryang Chung, Jeong Hoon Yang, Chi-Min Park, Gee Young Suh |
Abstract |
Acute respiratory distress syndrome (ARDS) is potentially underrecognized by clinicians. Early recognition and subsequent optimal treatment of patients with ARDS may be facilitated by usage of biomarkers. Surfactant protein D (SP-D), a marker of alveolar epithelial injury, has been proposed as a potentially useful biomarker for diagnosis of ARDS in a few studies. We tried to validate the performance of plasma SP-D levels for diagnosis of ARDS. We conducted a retrospective analysis using data from three (two in USA and one in Korea) prospective biobank cohorts involving 407 critically ill patients admitted to medical intensive care unit (ICU). A propensity score matched analysis (patients with versus without ARDS, matched 1:1) was carried out using significant variables from multiple logistic regression. The diagnostic accuracy of plasma SP-D as a diagnostic marker of ARDS was assessed by receiver operating characteristic curve analysis. Out of the 407 subjects included in this study, 39 (10%) patients fulfilled ARDS criteria. Patients with ARDS had higher SP-D levels in plasma (p < 0.01) and higher hospital-mortality (p < 0.001) than those without ARDS. Thirty eight subjects with ARDS (cases) were successfully matched for propensity for ARDS with 38 subjects without ARDS (controls). Plasma levels of SP-D were higher in cases with ARDS compared to their matched controls without ARDS [median 20.8 ng/mL (interquartile range, 12.7-38.4) versus 7.9 (4.1-17.0); p = 0.001]. The area under the receiver operating characteristic curve for SP-D for the diagnosis of ARDS was 0.71 (95% confidence intervals, 0.60-0.83). A cut-off point of 12.7 ng/mL for SP-D yielded sensitivity of 74% and specificity of 63%. High levels of SP-D within 48 h after ICU admission might serve as a diagnostic marker for ARDS in patients hospitalized in medical ICU. Further prospective trials are required to validate the diagnostic role of SP-D in ARDS, and if its usefulness is greater in direct than in indirect ARDS, as well as across different strata of severity of ARDS. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 44 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 10 | 23% |
Student > Ph. D. Student | 6 | 14% |
Student > Bachelor | 6 | 14% |
Student > Doctoral Student | 4 | 9% |
Other | 3 | 7% |
Other | 9 | 20% |
Unknown | 6 | 14% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 15 | 34% |
Biochemistry, Genetics and Molecular Biology | 6 | 14% |
Immunology and Microbiology | 3 | 7% |
Agricultural and Biological Sciences | 2 | 5% |
Nursing and Health Professions | 2 | 5% |
Other | 7 | 16% |
Unknown | 9 | 20% |