OUT-3: PROGNOSTIC VALUE OF PHENYL CARBOXYLIC ACIDS LEVEL IN PATIENT SERUM WITH ACUTE ABDOMEN

• Published in: Shock (Augusta, Ga.) Vol. 44 Suppl 2; p. 13
• Main Authors: Beloborodova, N.V, Moroz, V.V, Osipov, A.A, Vlasenko, A.V, Fateev, K.M, Sarshor, Yu.N, Pautova, A.K, Bedova, A.Yu
• Format: Journal Article
• Language: English
• Published: by the Shock Society 01-10-2015
• ISSN: 1073-2322; 1540-0514
• DOI: 10.1097/01.shk.0000472043.92383.4c

INTRODUCTION:Simple prognostic marker search remains relevant for patients with acute abdomen. Previously it was shown that the levels of aromatic amino acid metabolites (phenyl carboxylic acids - PhCAs) are significantly increased in septic and other critically ill patients [http://ccforum.com/content/18/S2/P60].
METHODS:In the present study we performed ROC-analysis for total level of four clinically significant PhCAs, namelyphenylacetic(PAA), phenyllactic(PLA), p-hydroxyphenyllactic(p-HPLA), p- hydroxyphenylacetic(p-HPAA)∑4PhCAs. Normal level of ∑4PhCAs is 2,3–8,7 μM. Serum samples were collected from critically ill patients with acute abdomen (n = 57, male 44%) admitted to the ICU immediately after emergency surgery. Acute abdomen development was associated with perforation of the small intestine (n = 13) or colon (n = 12), intestinal obstruction (n = 16), mesenteric ischemia (n = 10) and appendicitis (n = 6). The average patient age was 66 ± 17 years, APACHE II Score totaled 11,7 ± 9,1. The PhCA levels were measured chromatographically (GC-FID). Statistical processing was carried out using IBM SPSS Statistics 22 program.
RESULTS:Mortality rate amounted to 44% (n = 25). The area under the prognostic ROC curve (Fig. 1) for ∑4PhCAs totaled 0,913 (CI 0,834–0,991, p < 0,001), for APACHE II Score – 0,937 (CI 0,866–1,000; p < 0,001). The cut-off value for ∑4PhCAs was 11,7 μM (sensitivity 76%, specificity 91%), for APACHE II – 12 points (sensitivity 84%, specificity 97%).(Figure is included in full-text article.)
CONCLUSION:The total serum level of 4PhCAs and APACHE II Score have comparable predictive power for patients with acute abdomen. Thus, aromatic amino acid metabolites (PhCAs) can be attributed to the promising prognostic indicators for integrated patient severity assessment. Supported by Russian Science Foundation Grant №15–15-00110.