Associations between YKL-40 and markers of disease severity and death in patients with necrotizing soft-tissue infection

Necrotizing soft-tissue infection (NSTI) is a severe and fast-progressing bacterial infection. Prognostic biomarkers may provide valuable information in treatment guidance and decision-making, but none have provided sufficient robustness to have a clinical impact. YKL-40 may reflect the ongoing path...

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Published in:BMC infectious diseases 2021-10, Vol.21 (1), p.1046-1046, Article 1046
Main Authors: Hedetoft, Morten, Hansen, Marco Bo, Madsen, Martin Bruun, Johansen, Julia Sidenius, Hyldegaard, Ole
Format: Article
Language:English
Subjects:
Accuracy
Acute phase proteins
Age
Bacterial diseases
Bacterial infections
Biochemistry
Biological markers
Biomarkers
Chitinase-3-Like Protein 1
Chitinase-3-like-1 protein
Clinical endpoint
Decision making
Fournier’s gangrene
Health aspects
Humans
Immune system
Infections
Infectious diseases
Infectious skin diseases
Inflammation
Mortality
Necrosis
Necrotizing fasciitis
Patient outcomes
Patients
Physiology
Plasma
Prognosis
Regression analysis
Sepsis
Septic shock
Severity of Illness Index
Sex
Shock, Septic
Soft Tissue Infections
Survival
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description Necrotizing soft-tissue infection (NSTI) is a severe and fast-progressing bacterial infection. Prognostic biomarkers may provide valuable information in treatment guidance and decision-making, but none have provided sufficient robustness to have a clinical impact. YKL-40 may reflect the ongoing pathological inflammatory processes more accurately than traditional biomarkers as it is secreted by the activated immune cells, but its prognostic yields in NSTI remains unknown. For this purpose, we investigated the association between plasma YKL-40 and 30-day mortality in patients with NSTI, and assessed its value as a marker of disease severity. We determined plasma YKL-40 levels in patients with NSTI (n = 161) and age-sex matched controls (n = 65) upon admission and at day 1, 2 and 3. Baseline plasma YKL-40 was 1191 ng/mL in patients with NSTI compared with 40 ng/mL in controls (p 
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Prognostic biomarkers may provide valuable information in treatment guidance and decision-making, but none have provided sufficient robustness to have a clinical impact. YKL-40 may reflect the ongoing pathological inflammatory processes more accurately than traditional biomarkers as it is secreted by the activated immune cells, but its prognostic yields in NSTI remains unknown. For this purpose, we investigated the association between plasma YKL-40 and 30-day mortality in patients with NSTI, and assessed its value as a marker of disease severity. We determined plasma YKL-40 levels in patients with NSTI (n = 161) and age-sex matched controls (n = 65) upon admission and at day 1, 2 and 3. Baseline plasma YKL-40 was 1191 ng/mL in patients with NSTI compared with 40 ng/mL in controls (p &lt; 0.001). YKL-40 was found to be significantly higher in patients with septic shock (1942 vs. 720 ng/mL, p &lt; 0.001), and in patients receiving renal-replacement therapy (2382 vs. 1041 ng/mL, p &lt; 0.001). YKL-40 correlated with Simplified Acute Physiology Score II (Rho 0.33, p &lt; 0.001). Baseline YKL-40 above 1840 ng/mL was associated with increased risk of 30-day mortality in age-sex-comorbidity adjusted analysis (OR 3.77, 95% CI; 1.59-9.24, p = 0.003), but after further adjustment for Simplified Acute Physiology Score II no association was found between YKL-40 and early mortality. High plasma YKL-40 to be associated with disease severity, renal-replacement therapy and risk of death in patients with NSTI. 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Prognostic biomarkers may provide valuable information in treatment guidance and decision-making, but none have provided sufficient robustness to have a clinical impact. YKL-40 may reflect the ongoing pathological inflammatory processes more accurately than traditional biomarkers as it is secreted by the activated immune cells, but its prognostic yields in NSTI remains unknown. For this purpose, we investigated the association between plasma YKL-40 and 30-day mortality in patients with NSTI, and assessed its value as a marker of disease severity. We determined plasma YKL-40 levels in patients with NSTI (n = 161) and age-sex matched controls (n = 65) upon admission and at day 1, 2 and 3. Baseline plasma YKL-40 was 1191 ng/mL in patients with NSTI compared with 40 ng/mL in controls (p &lt; 0.001). YKL-40 was found to be significantly higher in patients with septic shock (1942 vs. 720 ng/mL, p &lt; 0.001), and in patients receiving renal-replacement therapy (2382 vs. 1041 ng/mL, p &lt; 0.001). YKL-40 correlated with Simplified Acute Physiology Score II (Rho 0.33, p &lt; 0.001). Baseline YKL-40 above 1840 ng/mL was associated with increased risk of 30-day mortality in age-sex-comorbidity adjusted analysis (OR 3.77, 95% CI; 1.59-9.24, p = 0.003), but after further adjustment for Simplified Acute Physiology Score II no association was found between YKL-40 and early mortality. High plasma YKL-40 to be associated with disease severity, renal-replacement therapy and risk of death in patients with NSTI. 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1471-2334
language eng
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source Publicly Available Content Database; PubMed Central
subjects Accuracy
Acute phase proteins
Age
Bacterial diseases
Bacterial infections
Biochemistry
Biological markers
Biomarkers
Chitinase-3-Like Protein 1
Chitinase-3-like-1 protein
Clinical endpoint
Decision making
Fournier’s gangrene
Health aspects
Humans
Immune system
Infections
Infectious diseases
Infectious skin diseases
Inflammation
Mortality
Necrosis
Necrotizing fasciitis
Patient outcomes
Patients
Physiology
Plasma
Prognosis
Regression analysis
Sepsis
Septic shock
Severity of Illness Index
Sex
Shock, Septic
Soft Tissue Infections
Survival
title Associations between YKL-40 and markers of disease severity and death in patients with necrotizing soft-tissue infection
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