A suPAR level below 4 ng/mL can be a useful discharge marker.

suPAR cut-offs <4, between 4-6 and >6 ng/mL can identify acute medical patients who have low, medium, or high risk of 30- and 90-day mortality.

In this new study, researchers conducted a prospective observational analysis on acute medical patients at Mikkeli Hospital in Finland. They used the suPARnostic® Turbilatex assay on a Cobas c501 (Roche DiagnosticsLtd) analyzer to measure suPAR levels. The study tested previously suggested suPAR cut-offs that might indicate low-medium and high risk for 30- and 90-day follow-up.

The findings reveal significant prognostic value of suPAR in patients. Those with a suPAR level under 4 ng/mL present a low risk of dying within 30 and 90 days (less than 1%), while the 90-day death rate climbs to over 20% in patients with suPAR levels above 6 ng/mL. The high negative predictive value for patients with suPAR levels under 4 ng/mL supports using this measure, along with other clinical findings, to decide on patient discharge.

Important results:

• suPAR, independently of age, sex, and C-reactive protein levels, predicted 30- and 90-day mortality.
• Among the 1747 acute medical patients, almost half had a suPAR level below 4 ng/mL, and the 30- and 90-day risk of mortality in these patients was below 1%.
• Patients with suPAR above 6 ng/mL (1 in 4 patients) had high 90-day mortality of 20%.

Conclusion:

suPAR cut-offs of below 4, between 4-6, and above 6 ng/mL can identify acute medical patients who have a low, medium, or high risk of 30- and 90-day mortality. A suPAR level below 4 ng/mL can thus be useful as a discharge marker. The turbidimetric assay provides fast results that can improve decisions of discharge or admission of acute medical patients.