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Neutrophil CD64 expression is a predictor of mortality for patients in the intensive care unit
Qiqi Chen1, Junfeng Shi1, Aihua Fei1
1Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University Medical College Shanghai, China.
Insights
Neutrophil CD64 shows strong potential for predicting intensive care unit (ICU) mortality, performing better than CRP and FT3. Combined with APACHE II scores, CD64 can enhance mortality prediction accuracy.
Area of Science:
- Critical Care Medicine
- Biomarker Discovery
- Infectious Disease Diagnostics
Background:
- Neutrophil CD64 is a recognized biomarker for bacterial infections and sepsis.
- The prognostic capability of CD64 for predicting survival in intensive care unit (ICU) patients remains uncertain.
Purpose of the Study:
- To investigate the prognostic value of neutrophil CD64 in predicting ICU mortality.
- To compare the predictive performance of CD64 with established markers like APACHE II, CRP, and FT3.
Main Methods:
- A cohort of 797 ICU patients was analyzed.
- Neutrophil CD64, thyroid hormone (FT3), C-reactive protein (CRP), and APACHE II scores were measured.
- Receiver operating characteristic (ROC) curves and Area Under the Curve (AUC) were used to assess predictive accuracy for mortality.
Main Results:
- Neutrophil CD64 demonstrated a higher AUC (0.752) for predicting mortality than FT3 (0.696) and CRP (0.672).
- APACHE II scores yielded the highest AUC (0.872).
- Neutrophil CD64 expression positively correlated with CRP and APACHE II scores, and negatively with FT3. CD64 independently predicted ICU mortality.
Conclusions:
- Neutrophil CD64 exhibits significant power in predicting ICU mortality, second only to APACHE II scores.
- CD64, when used in conjunction with APACHE II scores, can potentially improve the accuracy of mortality outcome prediction in ICU patients.
Background:
Neutrophil CD64 has been shown to be a promising biomarker for bacterial infection and sepsis identification. However, the prognostic value of CD64 in predicting the likelihood of survival for patients in intensive care unit (ICU) is unclear.
Methods:
A total of 797 patients in the ICU of Xin-Hua Hospital, Shanghai, China were enrolled. We determined the Acute Physiology and Chronic Health Evaluation II (APACHE II) scores from these patients and collected blood samples to measure the levels of neutrophil CD64, thyroid hormone and C-reactive protein (CRP). We assessed the association between APACHE II scores or these biomarkers and mortality of patients in the ICU. Receiver operating characteristic (ROC) curves were generated and the Area Under the Curve (AUC) for each indicator was determined.
Results:
The AUC for CD64 was 0.752 ± 0.026, which was higher than that of FT3 (0.696 ± 0.028) and CRP (0.672 ± 0.026). APACHE II scores had the highest AUC (0.872 ± 0.018). The level of neutrophil CD64 expression positively associated with CRP and APACHE II, and negatively correlated with FT3. Multiple regression analysis revealed that APACHE II scores (Standard β value = 0.183, P < 0.001), CD64 (Standard β value = 0.518, P < 0.001) or log (CRP) (Standard β value = 1.203, P < 0.001) independently predicted ICU mortality.
Conclusion:
CD64 had the greatest power for predicting ICU mortality other than APACHE II scores. This result indicates that CD64 may be used as a biomarker to in combination with the use of APACHE II scores to improve the accuracy of predicting mortality outcome for patients in the ICU.
