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Diagnostics
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Predictive and Prognostic Markers in Critically Ill Patients, 2nd Edition
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Predictive and Prognostic Markers in Critically Ill Patients, 2nd Edition

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 30 April 2025 | Viewed by 2825

Special Issue Editors

Dr. Silvia De Rosa

E-Mail Website
Guest Editor
1. Centre for Medical Sciences—CISMed, University of Trento, Via S. Maria, Maddalena 1, 38122 Trento, Italy
2. Anesthesia and Intensive Care, Santa, Chiara Regional Hospital, APSS, Trento, Italy
Interests: acute brain injury; acute kidney injury; blood purification in sepsis; airway management; infectious disease; extracorporeal organ support; nutrition and metabolism in critical care
Special Issues, Collections and Topics in MDPI journals
Dr. Sergio Lassola

E-Mail Website
Co-Guest Editor
Anesthesia and Intensive Care, Santa Chiara Regional Hospital, APSS, 38122 Trento, Italy
Interests: hemodynamics; mechanical ventilation; acute kidney injury; sepsis

Special Issue Information

Dear Colleagues,

We are delighted to present a Special Issue in Section Pathology and Molecular Diagnostics: “Predictive and Prognostic Markers in Critically Ill Patients, 2nd Edition”.

Today, with the exponential growth in biomarker research, there is enthusiasm that our expanding knowledge will translate into improved decision making and outcomes. Continuous evaluation of our practice and incorporation of these new ideas and studies has the potential to improve patient care. Prognostic biomarkers may predict the course or trajectory of disease, allowing for early determination of disposition and goals of care. The future development and adoption of guidelines and protocols using biomarkers has the potential to minimize variability and maximize benefit. Through thoughtful study design and collaboration, the biomarker era will surely transform and shape the future of medicine.

Therefore, Diagnostics is proud to offer this platform to promote and to highlight evaluable research on predictive and prognostic markers in the specific field of critical care medicine.

Dr. Silvia De Rosa
Dr. Sergio Lassola
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • acute brain injury
  • acute kidney injury
  • acute mesenteric ischemia
  • acute pancreatitis
  • acute respiratory failure
  • heart failure
  • infectious disease

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Published Papers (2 papers)

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Research

11 pages, 1519 KiB  
Article
Hemolysis Index Correlations with Plasma-Free Hemoglobin and Plasma Lactate Dehydrogenase in Critically Ill Patients under Extracorporeal Membrane Oxygenation or Mechanical Circulatory Support—A Single-Center Study
by Bernhard Zapletal, Daniel Zimpfer, Thomas Schlöglhofer, Monika Fritzer-Szekeres, Thomas Szekeres, Martin H. Bernardi, Johannes Geilen, Marcus J. Schultz and Edda M. Tschernko
Diagnostics 2024, 14(7), 680; https://doi.org/10.3390/diagnostics14070680 - 23 Mar 2024
Viewed by 1450
Abstract
Monitoring for thrombosis and hemolysis is crucial for patients under extracorporeal or mechanical circulatory support, but it can be costly. We investigated correlations between hemolysis index (HI) and plasma-free hemoglobin (PFH) levels on one hand, and between the HI and plasma lactate dehydrogenase [...] Read more.
Monitoring for thrombosis and hemolysis is crucial for patients under extracorporeal or mechanical circulatory support, but it can be costly. We investigated correlations between hemolysis index (HI) and plasma-free hemoglobin (PFH) levels on one hand, and between the HI and plasma lactate dehydrogenase (LDH) levels on the other, in critically ill patients with and without extracorporeal or mechanical circulatory support. Additionally, we calculated the cost reductions if monitoring through HI were to replace monitoring through PFH or plasma LDH. In a single-center study, HI was compared with PFH and plasma LDH levels in blood samples taken for routine purposes in critically ill patients with and without extracorporeal or mechanical circulatory support. A cost analysis, restricted to direct costs associated with each measurement, was made for an average 10-bed ICU. This study included 147 patients: 56 patients with extracorporeal or mechanical circulatory support (450 measurements) and 91 patients without extracorporeal or mechanical circulatory support (562 measurements). The HI correlated well with PFH levels (r = 0.96; p < 0.01) and poorly with plasma LDH levels (r = 0.07; p < 0.01) in patients with extracorporeal or mechanical circulatory support. Similarly, HI correlated well with PFH levels (r = 0.97; p < 0.01) and poorly with plasma LDH levels (r = −0.04; p = 0.39) in patients without extracorporeal or mechanical circulatory support. ROC analyses demonstrated a strong performance of HI, with the curve indicating excellent discrimination in the whole cohort (area under the ROC of 0.969) as well as in patients under ECMO or mechanical circulatory support (area under the ROC of 0.988). Although the negative predictive value of HI for predicting PFH levels > 10 mg/dL was high, its positive predictive value was found to be poor at various cutoffs. A simple cost analysis showed substantial cost reduction if HI were to replace PFH or plasma LDH for hemolysis monitoring. In conclusion, in this cohort of critically ill patients with and without extracorporeal or mechanical circulatory support, HI correlated well with PFH levels, but poorly with plasma LDH levels. Given the high correlation and substantial cost reductions, a strategy utilizing HI may be preferable for monitoring for hemolysis compared to monitoring strategies based on PFH or plasma LDH. The PPV of HI, however, is unacceptably low to be used as a diagnostic test. Full article
(This article belongs to the Special Issue Predictive and Prognostic Markers in Critically Ill Patients, 2nd Edition)
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11 pages, 713 KiB  
Article
Association between Red Cell Distribution Width and Outcomes of Nonagenarians Admitted to the Intensive Care Unit—A Retrospective Cohort Study
by Pauline Theile, Jakob Müller, Rikus Daniels, Stefan Kluge and Kevin Roedl
Diagnostics 2023, 13(20), 3279; https://doi.org/10.3390/diagnostics13203279 - 23 Oct 2023
Cited by 1 | Viewed by 888
Abstract
The red cell distribution width (RDW) measures the heterogeneity of the erythrocyte volume. Different clinical conditions are associated with increased RDW, and high levels (>14.5%) have been described as a predictive marker for unfavorable outcomes and mortality in critically ill patients. However, there [...] Read more.
The red cell distribution width (RDW) measures the heterogeneity of the erythrocyte volume. Different clinical conditions are associated with increased RDW, and high levels (>14.5%) have been described as a predictive marker for unfavorable outcomes and mortality in critically ill patients. However, there is a lack of data on very elderly critically ill patients. Therefore, we aimed to investigate the association of RDW with outcomes in critically ill patients ≥ 90 years. A retrospective analysis was conducted for all consecutive critically ill patients ≥ 90 years who were admitted to the Department of Intensive Care Medicine of the Medical University Centre Hamburg-Eppendorf (Hamburg, Germany) with available RDW on admission. Clinical course and laboratory were analyzed for all patients with eligible RDW. High RDW was defined as (>14.5%). We clinically assessed factors associated with mortality. Univariable and multivariable Cox regression analysis was performed to determine the prognostic impact of RDW on 28-day mortality. During a 12-year period, we identified 863 critically ill patients ≥ 90 years old with valid RDW values and complete clinical data. In total, 32% (n = 275) died within 28 days, and 68% (n = 579) survived for 28 days. Median RDW levels on ICU admission were significantly higher in non-survivors compared with survivors (15.6% vs. 14.8%, p < 0.001). Overall, 38% (n = 327) had low, and 62% (n = 536) had high RDW. The proportion of high RDW (>14.5%) was significantly higher in non-survivors (73% vs. 57%, p < 0.001). Patients with low RDW presented with a lower Charlson Comorbidity Index (p = 0.014), and their severity of illness on admission was lower (SAPS II: 35 vs. 38 points, p < 0.001). In total, 32% (n = 104) in the low and 35% (n = 190) in the high RDW group were mechanically ventilated (p = 0.273). The use of vasopressors (35% vs. 49%, p < 0.001) and renal replacement therapy (1% vs. 5%, p = 0.007) was significantly higher in the high RDW group. Cox regression analysis demonstrated that high RDW was significantly associated with 28-day mortality [crude HR 1.768, 95% CI (1.355–2.305); p < 0.001]. This association remained significant after adjusting for multiple confounders [adjusted HR 1.372, 95% CI (1.045–1.802); p = 0.023]. High RDW was significantly associated with mortality in critically ill patients ≥ 90 years. RDW is a useful simple parameter for risk stratification and may aid guidance for the therapy in very elderly critically ill patients. Full article
(This article belongs to the Special Issue Predictive and Prognostic Markers in Critically Ill Patients, 2nd Edition)
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