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Prospective validation of an 11-gene mRNA host response score for mortality risk stratification in the intensive care unit
- Source :
- Scientific Reports, Scientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
- Publication Year :
- 2020
-
Abstract
- Several clinical calculators predict intensive care unit (ICU) mortality, however these are cumbersome and often require 24 h of data to calculate. Retrospective studies have demonstrated the utility of whole blood transcriptomic analysis in predicting mortality. In this study, we tested prospective validation of an 11-gene messenger RNA (mRNA) score in an ICU population. Whole blood mRNA from 70 subjects in the Stanford ICU Biobank with samples collected within 24 h of Emergency Department presentation were used to calculate an 11-gene mRNA score. We found that the 11-gene score was highly associated with 60-day mortality, with an area under the receiver operating characteristic curve of 0.68 in all patients, 0.77 in shock patients, and 0.98 in patients whose primary determinant of prognosis was acute illness. Subjects with the highest quartile of mRNA scores were more likely to die in hospital (40% vs 7%, p 24 h after emergency department presentation. Tests will target a 30-min turnaround time, allowing for rapid results early in admission. Moving forward, this test may provide valuable real-time prognostic information to improve triage decisions and allow for enrichment of clinical trials.
- Subjects :
- Male
medicine.medical_specialty
Science
Population
Predictive medicine
Gene Expression
Risk Assessment
Article
law.invention
03 medical and health sciences
0302 clinical medicine
law
Medicine
Humans
Hospital Mortality
Prospective Studies
RNA, Messenger
Mortality
education
Transcriptomics
Aged
Aged, 80 and over
education.field_of_study
Multidisciplinary
Receiver operating characteristic
business.industry
Gene Expression Profiling
030208 emergency & critical care medicine
Retrospective cohort study
Emergency department
Middle Aged
Prognosis
Triage
Intensive care unit
Clinical trial
Intensive Care Units
030228 respiratory system
Quartile
ROC Curve
Emergency medicine
Female
business
Emergency Service, Hospital
Transcriptome
Biomarkers
Subjects
Details
- ISSN :
- 20452322
- Volume :
- 11
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Scientific reports
- Accession number :
- edsair.doi.dedup.....414eb0bade215fa6236401187a814de6