TY  - JOUR
PY  - 2020//
TI  - PenKid measurement at admission is associated with outcome in severely ill burn patients
JO  - Burns: journal of the International Society for Burn Injuries
A1  - Depret, François
A1  - Polina, Adrien
A1  - Amzallag, Juliette
A1  - Fayolle-Pivot, Laure
A1  - Coutrot, Maxime
A1  - Chaussard, Maïté
A1  - Struck, Joachim
A1  - Hartmann, Oliver
A1  - Jully, Marion
A1  - Fratani, Alexandre
A1  - Oueslati, Haikel
A1  - Cupaciu, Alexandru
A1  - Soussi, Sabri
A1  - Benyamina, Mourad
A1  - Guillemet, Lucie
A1  - Mebazaa, Alexandre
A1  - Textoris, Julien
A1  - Legrand, Matthieu
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Proenkephalin A 119-159 (penKid) has been proposed as a sensitive biomarker of renal function. This study evaluated the association of concentrations of plasma penKid with death and risk of acute kidney injury (AKI) in severely ill burn patients. <br><br>METHODS: A prospective observational study in two centers with severely ill adult burn patients was conducted. The inclusion criteria were total body surface area (TBSA) burns >15%, with burn injury occurring <72 h before intensive care unit (ICU) admission and plasma sample taken at admission. The primary endpoint was 90-day mortality. The secondary endpoints were AKI and a combined endpoint of 90-day mortality and/or AKI. Mortality was also evaluated in the sub-group of patients with sub-clinical AKI, defined as a patient without AKI but with elevated penKid. <br><br>RESULTS: A total of 113 consecutive patients were enrolled. The median age was 48 years (Interquartile range [IQR] 33-64), the median burn TBSA was 35% (IQR 25-53), and 90-day mortality was 31.9%. Thirty-one percent of the patients had AKI, and 41.6% of patients had the combined endpoint. There was a stepwise decrease in survival from patients without AKI, sub-AKI, and with AKI (survival rate 90.0% [95% CI 82.7-97.9], 66.7% [95% CI 48.1-92.4], and 31.4% [95% CI 19.3-51.3], respectively, p < 0.001). Plasma penKid concentration was significantly higher in non-survivors compared to survivors (86.9 pmol/L [IQR 53.3-166.1] versus 52.9 pmol/L [IQR 37.1-70.7]; p = 0.0001) and in patients with AKI compared to patients without AKI (86.4 pmol/L [IQR 56.5-153.4] versus 52.5 pmol/L [IQR 35.5-71.2]; p < 0.001). Penkid provided added value on top of serum creatinine (Screat) and Sepsis Related Organ Failure Assessment (SOFA) scores to predict 90-day mortality (combined c-index of 0.738 versus 0.707; p = 0.024 and 0.787 versus 0.752; p < 0.001). <br><br>CONCLUSIONS: Plasma penKid concentration at admission was associated with an increased risk of death in burn patients. PenKid has additional prognostic value on top of Screat and SOFA to predict 90-day mortality.<br><br>Copyright © 2020 Elsevier Ltd and ISBI. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0305-4179
UR  - http://dx.doi.org/10.1016/j.burns.2020.01.002
ID  - ref1
ER  -