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Jackson TC, Herrmann JR, Fink EL, Au AK, Kochanek PM. Harnessing the Promise of the Cold Stress Response for Acute Brain Injury and Critical Illness in Infants and Children. Pediatr Crit Care Med 2024; 25:259-270. [PMID: 38085024 PMCID: PMC10932834 DOI: 10.1097/pcc.0000000000003424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Affiliation(s)
- Travis C. Jackson
- Department of Molecular Pharmacology & Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Jeremy R. Herrmann
- Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Children’s Hospital of Philadelphia, Philadelphia, PA
- Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Ericka L. Fink
- Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
| | - Alicia K. Au
- Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
| | - Patrick M. Kochanek
- Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
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Li M, Jiang LQ, Zhang MY, Liu SS, Sawh RRR, Zheng J, Yan Y, Hou SM, Lu KQ, Thorne O, Liu BC, Qian Q, Wu YF, Yang M, Wang B. Elevated serum FGF21 is an independent predictor for adverse events in hemodialysis patients from two large centers: a prospective cohort study. Ren Fail 2023; 45:2256414. [PMID: 37724523 PMCID: PMC10512844 DOI: 10.1080/0886022x.2023.2256414] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 09/02/2023] [Indexed: 09/21/2023] Open
Abstract
Introduction: We explored the relationship and the predictive value of serum fibroblast growth factor 21 (FGF21) with all-cause mortality, major adverse cardiovascular events (MACEs) and pneumonia in hemodialysis (HD) patients.Methods: A total of 388 Chinese HD patients from two HD centers were finally enrolled in this prospective cohort study (registration number: ChiCTR 1900028249) between January 2018 and December 2018. Serum FGF21 was detected. Patients were followed up with a median period of 47 months to record the MACEs and pneumonia until death or 31 December 2022.Results: The incidence of all-cause mortality, MACEs and pneumonia in HD patients were 20.6%, 29.6%, and 34.8%, respectively. The optimal cutoffs for FGF21 to predict all-cause mortality, MACEs and pneumonia were 437.57 pg/mL, 216.99 pg/mL and 112.79 pg/mL. Multivariate Cox regression analyses showed that FGF21, as a categorical variable, was an independent predictor for all-cause mortality, MACEs and pneumonia (HR, 3.357, 95% CI, 2.128-5.295, p < 0.001; HR, 1.575, 95% CI, 1.046-2.371, p = 0.029; HR, 1.784; 95% CI, 1.124-2.830; p = 0.014, respectively). The survival nomogram, MACEs-free survival nomogram and pneumonia-free survival nomogram based on FGF21 constructed for individualized assessment of HD patients had a high C-index with 0.841, 0.706 and 0.734.Conclusion: Higher serum FGF21 is an independent predictor of all-cause mortality, MACEs and pneumonia in HD patients.
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Affiliation(s)
- Min Li
- Department of Nephrology, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Li-qiong Jiang
- Institute of Nephrology, Southeast University Zhongda Hospital, Nanjing, China
- Department of Nephrology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Meng-yu Zhang
- Department of Nephrology, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Shu-su Liu
- Department of Nephrology, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | | | - Jing Zheng
- Institute of Nephrology, Southeast University Zhongda Hospital, Nanjing, China
| | - Yu Yan
- Institute of Nephrology, Southeast University Zhongda Hospital, Nanjing, China
| | - Shi-mei Hou
- Institute of Nephrology, Southeast University Zhongda Hospital, Nanjing, China
| | - Ke-qi Lu
- Institute of Nephrology, Southeast University Zhongda Hospital, Nanjing, China
| | - Obadele Thorne
- Department of Nephrology, Georgetown Public Hospital Corporation, Georgetown, Guyana
| | - Bi-cheng Liu
- Institute of Nephrology, Southeast University Zhongda Hospital, Nanjing, China
| | - Qing Qian
- Department of Pharmacy, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yan-feng Wu
- Department of Neurology, Nanjing Medical University Second Affiliated Hospital, Nanjing, China
| | - Min Yang
- Department of Nephrology, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Bin Wang
- Institute of Nephrology, Southeast University Zhongda Hospital, Nanjing, China
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Li X, Shen H, Zhou T, Cao X, Chen Y, Liang Y, Lu T, He J, Dou Z, Liu C, Tang Y, Zhu Z. Does an increase in serum FGF21 level predict 28-day mortality of critical patients with sepsis and ARDS? Respir Res 2021; 22:182. [PMID: 34154595 PMCID: PMC8216835 DOI: 10.1186/s12931-021-01778-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sepsis may be accompanied by acute respiratory distress syndrome (ARDS) in patients admitted to intensive care units (ICUs). It is essential to identify prognostic biomarkers in patients with sepsis and ARDS. OBJECTIVE Determine whether changes in the level of serum fibroblast growth factor 21 (FGF21) can predict the 28-day mortality of ICU patients with sepsis and ARDS. METHODS Consecutive sepsis patients were divided into two groups (Sepsis + ARDS and Sepsis-only), and the Sepsis + ARDS group was further classified as survivors or non-survivors. Demographic data and comorbidities were recorded. The Sequential Organ Failure Assessment (SOFA) score and serum levels of cytokines and other biomarkers were recorded 3 times after admission. Multiple Cox proportional hazards regression was used to identify risk factors associated with 28-day mortality in the Sepsis + ARDS group. Multivariate receiver operating characteristic curve analysis was used to assess the different predictive value of FGF21 and SOFA. RESULTS The Sepsis + ARDS group had a greater baseline SOFA score and serum levels of cytokines and other biomarkers than the Sepsis-only group; the serum level of FGF21 was almost twofold greater in the Sepsis + ARDS group (P < 0.05). Non-survivors in the Sepsis + ARDS group had an almost fourfold greater level of FGF21 than survivors in this group (P < 0.05). The serum level of FGF21 persistently increased from the baseline to the peak of shock and death in the non-survivors, but persistently decreased in survivors (P < 0.05). Changes in the serum FGF21 level between different time points were independent risk factors for mortality. No statistical difference was observed between the AUC of FGF21 and SOFA at baseline. CONCLUSION: A large increase of serum FGF21 level from baseline is associated with 28-day mortality in ICU patients with sepsis and ARDS.
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Affiliation(s)
- Xing Li
- Department of Critical Care, Changsha of Traditional Chinese Medicine Hospital, No. 22, Xingsha Road, Changsha, 410010, Hunan Province, People's Republic of China
| | - Hua Shen
- Department of Critical Care, Changsha of Traditional Chinese Medicine Hospital, No. 22, Xingsha Road, Changsha, 410010, Hunan Province, People's Republic of China
| | - Tinghong Zhou
- Department of Critical Care, Changsha of Traditional Chinese Medicine Hospital, No. 22, Xingsha Road, Changsha, 410010, Hunan Province, People's Republic of China
| | - Xiaoyu Cao
- Department of Critical Care, Changsha of Traditional Chinese Medicine Hospital, No. 22, Xingsha Road, Changsha, 410010, Hunan Province, People's Republic of China
| | - Ying Chen
- Department of Critical Care, Changsha of Traditional Chinese Medicine Hospital, No. 22, Xingsha Road, Changsha, 410010, Hunan Province, People's Republic of China
| | - Yan Liang
- Department of Critical Care, Changsha of Traditional Chinese Medicine Hospital, No. 22, Xingsha Road, Changsha, 410010, Hunan Province, People's Republic of China
| | - Ting Lu
- Department of Critical Care, Changsha of Traditional Chinese Medicine Hospital, No. 22, Xingsha Road, Changsha, 410010, Hunan Province, People's Republic of China
| | - Jiafen He
- Department of Critical Care, Changsha of Traditional Chinese Medicine Hospital, No. 22, Xingsha Road, Changsha, 410010, Hunan Province, People's Republic of China
| | - Zhoulin Dou
- Department of Critical Care, Changsha of Traditional Chinese Medicine Hospital, No. 22, Xingsha Road, Changsha, 410010, Hunan Province, People's Republic of China
| | - Chuankai Liu
- Department of Critical Care, Changsha of Traditional Chinese Medicine Hospital, No. 22, Xingsha Road, Changsha, 410010, Hunan Province, People's Republic of China
| | - Yong Tang
- Department of Critical Care, Changsha of Traditional Chinese Medicine Hospital, No. 22, Xingsha Road, Changsha, 410010, Hunan Province, People's Republic of China.
| | - Zexiang Zhu
- Department of Critical Care, Changsha of Traditional Chinese Medicine Hospital, No. 22, Xingsha Road, Changsha, 410010, Hunan Province, People's Republic of China.
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