Diagnostic and prognostic values of serum activin-a levels in patients with acute respiratory distress syndrome
Abstract Background We aimed to evaluate whether serum activin-A levels are elevated and have any value in predicting severity and prognosis in acute respiratory distress syndrome (ARDS). Methods Retrospective cohort study was performed with patients who were admitted to MICU with diagnosis of ARDS...
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doaj-1a833d9881fe473eb2203a3b885b39af2020-11-25T03:16:28ZengBMCBMC Pulmonary Medicine1471-24662019-06-011911810.1186/s12890-019-0879-6Diagnostic and prognostic values of serum activin-a levels in patients with acute respiratory distress syndromeJee-min Kim0Jung-Kyu Lee1Sun Mi Choi2Jinwoo Lee3Young Sik Park4Chang-Hoon Lee5Jae-Joon Yim6Chul-Gyu Yoo7Young Whan Kim8Sung Koo Han9Sang-Min Lee10Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical CenterDivision of Pulmonary and Critical Care Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical CenterDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineAbstract Background We aimed to evaluate whether serum activin-A levels are elevated and have any value in predicting severity and prognosis in acute respiratory distress syndrome (ARDS). Methods Retrospective cohort study was performed with patients who were admitted to MICU with diagnosis of ARDS and have serum samples stored within 48 h of Intensive care unit (ICU) admission between March 2013 and December 2016 at a single tertiary referral hospital. Serum activin-A levels were measured with ELISA kit, and were compared with those of normal healthy control and non-ARDS sepsis patients. Results Total 97 ARDS patients were included for the study. Levels of Activin-A were elevated in ARDS patients compared to those of healthy controls (Log-transformed activin-A levels 2.89 ± 0.36 vs. 2.34 ± 0.11, p < 0.001, absolute activin-A levels 1525.6 ± 1060.98 vs. 225.9 ± 30.1, p = 0.016) and non-ARDS sepsis patients (Log-transformed activin-A levels 2.89 ± 0.36 vs. 2.73 ± 0.34, p = 0.002, Absolute activin-A levels 1525.6 ± 1060.98 vs. 754.8 ± 123.5 pg/mL, p = 0.036). When excluding five outliers with extremely high activin-A levels, activin-A showed statistically significant correlation with in-hospital mortalities (In-hospital survivors 676.2 ± 407 vs. non-survivors 897.9 ± 561.9 pg/mL, p = 0.047). In predicting in-hospital mortality, serum activin-A concentrations showed superior area under curve compared to that of Acute physiologic and chronic health evaluation II scores (0.653; 95% CI [0541, 0.765] vs. 0.591, 95% CI [0.471, 0.710]). With cut-off level of 708 pg/mL, those with high serum activin-A levels had more than twofold increased risk of in-hospital mortalities. However, those relations were missing when outliers were in. Conclusions Serum activin-A levels in ARDS patients are elevated. However, its levels are weakly associated with ARDS outcomes.http://link.springer.com/article/10.1186/s12890-019-0879-6ActivinsHospital mortalityIntensive care unitsPrognosisRespiratory distress syndrome, adult |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jee-min Kim Jung-Kyu Lee Sun Mi Choi Jinwoo Lee Young Sik Park Chang-Hoon Lee Jae-Joon Yim Chul-Gyu Yoo Young Whan Kim Sung Koo Han Sang-Min Lee |
spellingShingle |
Jee-min Kim Jung-Kyu Lee Sun Mi Choi Jinwoo Lee Young Sik Park Chang-Hoon Lee Jae-Joon Yim Chul-Gyu Yoo Young Whan Kim Sung Koo Han Sang-Min Lee Diagnostic and prognostic values of serum activin-a levels in patients with acute respiratory distress syndrome BMC Pulmonary Medicine Activins Hospital mortality Intensive care units Prognosis Respiratory distress syndrome, adult |
author_facet |
Jee-min Kim Jung-Kyu Lee Sun Mi Choi Jinwoo Lee Young Sik Park Chang-Hoon Lee Jae-Joon Yim Chul-Gyu Yoo Young Whan Kim Sung Koo Han Sang-Min Lee |
author_sort |
Jee-min Kim |
title |
Diagnostic and prognostic values of serum activin-a levels in patients with acute respiratory distress syndrome |
title_short |
Diagnostic and prognostic values of serum activin-a levels in patients with acute respiratory distress syndrome |
title_full |
Diagnostic and prognostic values of serum activin-a levels in patients with acute respiratory distress syndrome |
title_fullStr |
Diagnostic and prognostic values of serum activin-a levels in patients with acute respiratory distress syndrome |
title_full_unstemmed |
Diagnostic and prognostic values of serum activin-a levels in patients with acute respiratory distress syndrome |
title_sort |
diagnostic and prognostic values of serum activin-a levels in patients with acute respiratory distress syndrome |
publisher |
BMC |
series |
BMC Pulmonary Medicine |
issn |
1471-2466 |
publishDate |
2019-06-01 |
description |
Abstract Background We aimed to evaluate whether serum activin-A levels are elevated and have any value in predicting severity and prognosis in acute respiratory distress syndrome (ARDS). Methods Retrospective cohort study was performed with patients who were admitted to MICU with diagnosis of ARDS and have serum samples stored within 48 h of Intensive care unit (ICU) admission between March 2013 and December 2016 at a single tertiary referral hospital. Serum activin-A levels were measured with ELISA kit, and were compared with those of normal healthy control and non-ARDS sepsis patients. Results Total 97 ARDS patients were included for the study. Levels of Activin-A were elevated in ARDS patients compared to those of healthy controls (Log-transformed activin-A levels 2.89 ± 0.36 vs. 2.34 ± 0.11, p < 0.001, absolute activin-A levels 1525.6 ± 1060.98 vs. 225.9 ± 30.1, p = 0.016) and non-ARDS sepsis patients (Log-transformed activin-A levels 2.89 ± 0.36 vs. 2.73 ± 0.34, p = 0.002, Absolute activin-A levels 1525.6 ± 1060.98 vs. 754.8 ± 123.5 pg/mL, p = 0.036). When excluding five outliers with extremely high activin-A levels, activin-A showed statistically significant correlation with in-hospital mortalities (In-hospital survivors 676.2 ± 407 vs. non-survivors 897.9 ± 561.9 pg/mL, p = 0.047). In predicting in-hospital mortality, serum activin-A concentrations showed superior area under curve compared to that of Acute physiologic and chronic health evaluation II scores (0.653; 95% CI [0541, 0.765] vs. 0.591, 95% CI [0.471, 0.710]). With cut-off level of 708 pg/mL, those with high serum activin-A levels had more than twofold increased risk of in-hospital mortalities. However, those relations were missing when outliers were in. Conclusions Serum activin-A levels in ARDS patients are elevated. However, its levels are weakly associated with ARDS outcomes. |
topic |
Activins Hospital mortality Intensive care units Prognosis Respiratory distress syndrome, adult |
url |
http://link.springer.com/article/10.1186/s12890-019-0879-6 |
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