Derivation of a prediction rule for posttraumatic organ failure using plasma DNA and other variables
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摘要The early identification of patients at high risk of developing posttraumatic organ failure would allow preventive therapies to be studied. In this study, highly sensitive and specific guidelines for the early prediction of posttraumatic organ failure (OF) and multiple organ dysfunction syndrome (MODS) using cell-free (plasma) DNA and other predictors of post-traumatic complications were derived. As plasma DNA increases after injury and may be used to predict acute lung injury (ALI), we hypothesized that in combination with other predictors it would predict the later development of OF and MODS. Eighty-three patients (69 males; median age, 36 years) were studied as a consequence of major trauma within 3.5 hours of injury (median time to sampling and assessment, 60 min). Plasma DNA was measured using a real-time, quantitative, polymerase chain reaction assay for the P-globin gene. OF and MODS occurred in 20/83 (24%) and 9/79 (11%) cases, respectively. At selected cutoff points, the sensitivity of plasma DNA for predicting OF and MODS ranged from 50% to 100%, specificity ranged from 74% to 95%, and the likelihood ratio ranged from 3.89 to 10.50. Other variables studied included serum albumin, creatine kinase, aspartate transaminase, lactate dehydrogenase, leukocyte count, hematocrit, injury severity score, maximal abbreviated injury score, and shock index. Using a classification and regression tree, plasma DNA and aspartate transaminase at optimal cutoffs predicted OF and MODS with an overall correct classification of 93% and 87%, respectively.
著者Rainer TH, Lo YMD, Chan LYS, Lam NYL, Lit LCW, Cocks RA
會議名稱2nd International Symposium on Circulating Nucleic Acids in Plasma or Serum held in conjunction with the 6th Annual Scientific Symposium of the Hong-Kong-Cancer-Institute
會議開始日20.02.2001
會議完結日21.02.2001
會議地點HONG KONG
期刊名稱Annals of the New York Academy of Sciences
出版年份2001
月份1
日期1
卷號945
出版社NEW YORK ACAD SCIENCES
頁次211 - 220
國際標準書號1-57331-378-5
國際標準期刊號0077-8923
電子國際標準期刊號1749-6632
語言英式英語
關鍵詞multiple organ dysfunction syndrome (MODS); organ failure (OF); plasma DNA; posttraumatic; prediction
Web of Science 學科類別Biochemistry & Molecular Biology; Multidisciplinary Sciences; Science & Technology - Other Topics

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