Enhancing Emergency Department Risk Stratification: New Study Suggests Role of suPAR Biomarker
Sun Jan 27 2019
In a recent abstract published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, researchers, led by Schultz M et al., shed light on a promising avenue for refining risk assessment in emergency departments. The study, titled “Availability of suPAR in Emergency Departments may Improve Risk Stratification: A Secondary Analysis of the TRIAGE III Trial,” investigated the potential of the soluble urokinase plasminogen activator receptor (suPAR) biomarker in enhancing prognostic accuracy.
The analysis involved 4420 patients, each categorized based on triage severity and suPAR measurement availability. Notably, suPAR exhibited a significantly superior predictive ability for mortality compared to traditional triage categorization. The area under the curve (AUC) for suPAR stood at 0.85, outperforming triage’s AUC of 0.71 (P < 0.001). Impressively, when suPAR and triage data were combined, the AUC climbed to 0.87.
A pivotal revelation from the study was the identification of the optimal suPAR cut-off point at 5.9 ng/mL using Youden’s index. This cut-off point allowed for a more precise classification of patients in terms of hospital admission and mortality risk. By incorporating this suPAR threshold, the reclassification of triage data was demonstrated to refine risk stratification significantly.
In conclusion, the research highlights the potential of integrating the prognostic suPAR biomarker with the existing triage system. Such an approach could substantially enhance the accuracy of short-term mortality predictions within the emergency department setting. Moreover, the study’s findings suggest that suPAR measurement, in conjunction with triage assessment, could revolutionize the identification of high and low-risk patients, paving the way for more effective and tailored medical interventions. As emergency medicine continues to evolve, this study opens new doors for precise patient management and improved outcomes.