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Plasma nuclear and mitochondrial DNA levels as predictors of outcome in severe sepsis patients in the emergency room
- Source :
- Journal of Translational Medicine, Vol 10, Iss 1, p 130 (2012), Journal of Translational Medicine
- Publication Year :
- 2012
- Publisher :
- BMC, 2012.
-
Abstract
- Background and aim The sensitivity and specificity of biomarkers and scoring systems used for predicting fatality of severe sepsis patients remain unsatisfactory. This study aimed to determine the prognostic value of circulating plasma DNA levels in severe septic patients presenting at the Emergency Department (ED). Methods Sixty-seven consecutive patients with severe sepsis and 33 controls were evaluated. Plasma DNA levels were estimated by real-time quantitative polymerase chain reaction assay using primers for the human β-hemoglobin and ND2 gene. The patients’ clinical and laboratory data on admission were analyzed. Results The median plasma nuclear and mitochondria DNA levels for severe septic patients on admission were significantly higher than those of the controls. The mean plasma nuclear DNA level on admission correlated with lactate concentration (γ = 0.36, p = 0.003) and plasma mitochondrial DNA on admission (γ = 0.708, p 0.001). Significant prognostic factors for fatality included mechanical ventilation within the first 24 hours (p = 0.013), mean sequential organ failure assessment (SOFA) score on admission (p = 0.04), serum lactate (p < 0.001), and both plasma nuclear and mitochondrial DNA on admission (p < 0.001). Plasma mitochondrial DNA was an independent predictor of fatality by stepwise logistic regression such that an increase by one ng/mL in level would increase fatality rate by 0.7%. Conclusion Plasma DNA has potential use for predicting outcome in septic patients arriving at the emergency room. Plasma mitochondrial DNA level on admission is a more powerful predictor than lactate concentration or SOFA scores on admission.
- Subjects :
- Male
medicine.medical_specialty
Mitochondrial DNA
Hospital mortality
medicine.medical_treatment
lcsh:Medicine
Gastroenterology
DNA, Mitochondrial
Polymerase Chain Reaction
General Biochemistry, Genetics and Molecular Biology
law.invention
Sepsis
law
Internal medicine
Case fatality rate
Medicine
Humans
Prospective Studies
Prospective cohort study
Polymerase chain reaction
Aged
DNA Primers
Mechanical ventilation
Cell Nucleus
Medicine(all)
Base Sequence
business.industry
Biochemistry, Genetics and Molecular Biology(all)
Research
lcsh:R
Case-control study
General Medicine
DNA
Nucleus DNA
Middle Aged
medicine.disease
Prognosis
Severe sepsis
Surgery
Real-time polymerase chain reaction
Case-Control Studies
Female
business
Emergency Service, Hospital
Subjects
Details
- Language :
- English
- ISSN :
- 14795876
- Volume :
- 10
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of Translational Medicine
- Accession number :
- edsair.doi.dedup.....bd1cc42ed80546e5d6a064c7c3e415bb