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Erschienen in: European Journal of Trauma and Emergency Surgery 6/2010

01.12.2010 | Original Article

Neutrophil-derived circulating free DNA (cf-DNA/NETs), a potential prognostic marker for mortality in patients with severe burn injury

verfasst von: Jens Altrichter, Siegfried Zedler, Robert Kraft, Eugen Faist, Steffen R. Mitzner, Martin Sauer, Joachim Windolf, Martin Scholz, Tim Lögters

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 6/2010

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Abstract

The predictive value of circulating free DNA/neutrophil extracellular traps (cf-DNA/NETs) has recently been shown in patients with major trauma for sepsis, multiple organ failure, and mortality. Here we report on the predictive potential of cf-DNA/NETs for mortality in patients with severe burn injury. In a prospective study 32 patients with severe burn injury were included. Blood samples were sequentially obtained on day 1, 3, 5, and 7 after admission. cf-DNA/NETs was directly quantified from plasma by means of rapid fluorescence assay. Time kinetics of cf-DNA/NETs were correlated with clinical data, C-reactive protein (CRP), procalcitonin (PCT), and interleukin (IL)-6. Furthermore sensitivity, specificity, and positive and negative predictive value, as well as receiver operation characteristic (ROC) curves were calculated. Seven patients died within the first month after burn injury. cf-DNA/NETs values from these patients were significantly increased already on day 1 and 3 after admission compared with patients who survived (p < 0.01). In contrast, PCT levels of nonsurvivors were significantly elevated on day 3 and 5 (p < 0.01), while CRP and IL-6 did not show any significant difference between survivors and nonsurvivors. At a cutoff of 255 ng/ml, cf-DNA/NETs had sensitivity of 0.8 and specificity of 0.74. ROC revealed largest areas under the curve (AUC) for cf-DNA/NETs on day 1 (0.851) and 3 (0.883) after admission. For all values between day 1 and 7, AUC was 0.815. cf-DNA/NETs seems to be a rapid, valuable marker for prediction of mortality in burn patients. A larger confirmation trial ought to be carried out.
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Metadaten
Titel
Neutrophil-derived circulating free DNA (cf-DNA/NETs), a potential prognostic marker for mortality in patients with severe burn injury
verfasst von
Jens Altrichter
Siegfried Zedler
Robert Kraft
Eugen Faist
Steffen R. Mitzner
Martin Sauer
Joachim Windolf
Martin Scholz
Tim Lögters
Publikationsdatum
01.12.2010
Verlag
Urban and Vogel
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 6/2010
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-010-0013-1

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