Soluble Urokinase Plasminogen Activator Receptor: A Promising Biomarker for Mortality Prediction Among Critical ED Patients

Abstract

Patients admitted to the emergency department (ED) are a highly diverse group in terms of the risk of death. In overcrowded EDs, it becomes crucial to quickly and reliably estimate the risk of death or significant health deterioration. For this purpose, the concentration of soluble urokinase plasminogen activator receptor (suPAR) in plasma has been studied in recent years in various patient populations. In the present study, we tested the hypothesis that measuring suPAR upon the ED admission of critically ill patients can identify those at the highest mortality risk. To verify this hypothesis, we analyzed the relationship between suPAR plasma concentration, other biochemical parameters, and Early Warning Scores (EWSs) on admission and survival to hospital discharge. The study group consisted of 61 ED patients with priority 1 in the Manchester Triage System (MTS), excluding patients with illness caused by environmental factors. Positive correlations between suPAR and inflammatory parameters such as CRP and PCT, as well as the warning scales MEWS, MEDS, and qSOFA, were confirmed. Plasma suPAR concentration on admission was found to be a promising predictor of in-hospital mortality. The study indicated the potential prognostic value of suPAR as the mortality risk predictor for a specific population of critically ill ED patients.