The prognostic and risk-stratified value of heart-type fatty acid-binding protein in septic patients in the emergency department.
PURPOSE
To evaluate the prognostic and risk-stratified ability of heart-type fatty acid-binding protein (H-FABP) in septic patients in the emergency department (ED).


MATERIALS AND METHODS
From August to November 2012, 295 consecutive septic patients were enrolled. Circulating H-FABP was measured. The predictive value of H-FABP for 28-day mortality, organ dysfunction on ED arrival, and requirement for mechanical ventilation or a vasopressor within 6 hours after ED arrival was assessed by the receiver operating characteristic curve and logistic regression and was compared with Acute Physiology and Chronic Health Evaluation (APACHE) II score, Mortality in Emergency Department Sepsis (MEDS) score, and Sequential Organ Failure Assessment score.


RESULTS
The 28-day mortality, APACHE II, MEDS, and Sequential Organ Failure Assessment scores were much higher in H-FABP-positive patients. The incidence of organ dysfunction at ED arrival and requirement for mechanical ventilation or a vasopressor within 6 hours after ED arrival was higher in H-FABP-positive patients. Heart-type fatty acid-binding protein was an independent predictor of 28-day mortality and organ dysfunction. The area under the receiver operating characteristic curve for H-FABP predicting 28-day mortality and organ dysfunction was 0.784 and 0.755, respectively. Combination of H-FABP and MEDS improved the performance of MEDS in predicting organ dysfunction, and the difference of AUC was statistically significant (P<.05). The combinations of H-FABP and MEDS or H-FABP and APACHE II also improved the prognostic value of MEDS and APACHE II, but the areas under the curve were not statistically different.


CONCLUSIONS
Heart-type fatty acid-binding protein was helpful for prognosis and risk stratification of septic patients in the ED.
['Chen|Yun-Xia|YX|', 'Li|Chun-Sheng|CS|']
D018806:APACHE D000368:Aged D000369:Aged, 80 and over D019540:Area Under Curve D015415:Biomarkers D004636:Emergency Service, Hospital D000074026:Fatty Acid Binding Protein 3 D050556:Fatty Acid-Binding Proteins D005260:Female D006801:Humans D016015:Logistic Models D008297:Male D008875:Middle Aged D011379:Prognosis D012372:ROC Curve D012121:Respiration, Artificial D018805:Sepsis D014662:Vasoconstrictor Agents
Sepsis Prognosis Risk stratification Heart-type fatty acid–binding protein