SuPAR correlates with mortality and clinical severity in patients with necrotizing soft-tissue infections: results from a prospective, observational cohort study

Sci Rep. 2019 Mar 25;9(1):5098. doi: 10.1038/s41598-019-41688-y.

Abstract

Necrotizing soft tissue infections (NSTI) have a 90-day mortality rate of 18-22%. Tools are needed for estimating the prognosis and severity of NSTI upon admission. We evaluated soluble urokinase-type plasminogen activator receptor (suPAR) levels at admission as a prognostic marker of NSTI severity and mortality. In a prospective, observational cohort study, suPAR was measured in 200 NSTI patients. We compared admission suPAR levels in survivors and non-survivors, patients with septic shock and non-shock, amputation and non-amputation, correlations with Simplified Acute Physiology Score II (SAPS II) and the Sequential Organ Failure Assessment (SOFA) score. Admission suPAR levels were higher in septic shock vs. non-septic shock patients (9.2 vs. 5.8 ng/mL, p-value < 0.001) and non-survivors vs. survivors (11 vs. 6.1 ng/mL, p-value < 0.001) and correlated with SAPS II (r = 0.52, p < 0.001) and SOFA score (r = 0.64, p < 0.001). Elevated suPAR upon admission was associated with 90-day mortality (log-rank test p < 0.001), however not after adjustment for age, sex, and SOFA score. The AUC for suPAR and 90-day mortality was 0.77. We found that suPAR is a promising candidate for prognosis and severity in patients with NSTI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers
  • Cohort Studies
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Receptors, Urokinase Plasminogen Activator / genetics
  • Receptors, Urokinase Plasminogen Activator / metabolism
  • Sepsis / metabolism
  • Sepsis / mortality
  • Sepsis / pathology
  • Shock, Septic / metabolism
  • Shock, Septic / mortality
  • Shock, Septic / pathology
  • Soft Tissue Infections / metabolism
  • Soft Tissue Infections / mortality*
  • Soft Tissue Infections / pathology*

Substances

  • Biomarkers
  • Receptors, Urokinase Plasminogen Activator