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A Combined Score of Circulating miRNAs Allows Outcome Prediction in Critically Ill Patients
Christoph Roderburg1,2, Fabian Benz3,4, Alexander Koch5
1Department of Medicine III, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany. Christoph.roderburg@charite.de.
Background And Aims:
Identification of patients with increased risk of mortality represents an important prerequisite for an adapted adequate and individualized treatment of critically ill patients. Circulating micro-RNA (miRNA) levels have been suggested as potential biomarkers at the intensive care unit (ICU), but none of the investigated miRNAs displayed a sufficient sensitivity or specificity to be routinely employed as a single marker in clinical practice.
Methods And Results:
We recently described alterations in serum levels of 7 miRNAs (miR-122, miR-133a, miR-143, miR-150, miR-155, miR-192, and miR-223) in critically ill patients at a medical ICU. In this study, we re-analyzed these previously published data and performed a combined analysis of these markers to unravel their potential as a prognostic scoring system in the context of critical illness. Based on the Youden's index method, cut-off values were systematically defined for dysregulated miRNAs, and a "miRNA survival score" was calculated. Patients with high scores displayed a dramatically impaired prognosis compared to patients with low values. Additionally, the predictive power of our score could be further increased when the patient's age was additionally incorporated into this score.
Conclusions:
We describe the first miRNA-based biomarker score for prediction of medical patients' outcome during and after ICU treatment. Adding the patients' age into this score was associated with a further increase in its predictive power. Further studies are needed to validate the clinical utility of this score in risk-stratifying critically ill patients.
Insights
A new miRNA survival score, using 7 micro-RNAs (miRNAs), predicts mortality risk in intensive care unit (ICU) patients. Incorporating patient age further enhances this biomarker score's predictive power for critical illness outcomes.
Area of Science:
- Biomarker discovery
- Critical care medicine
- Molecular diagnostics
Background:
- Identifying high-risk critically ill patients is crucial for tailored treatment.
- Circulating micro-RNAs (miRNAs) show potential as intensive care unit (ICU) biomarkers.
- No single miRNA has demonstrated sufficient accuracy for routine clinical use.
Purpose of the Study:
- To re-analyze previously published miRNA data from critically ill patients.
- To develop a prognostic scoring system using multiple miRNAs.
- To assess the combined predictive value of specific miRNAs for patient outcomes.
Main Methods:
- Re-analysis of serum levels of 7 specific miRNAs (miR-122, miR-133a, miR-143, miR-150, miR-155, miR-192, miR-223).
- Calculation of a 'miRNA survival score' based on defined cut-off values (Youden's index).
- Evaluation of the score's predictive power, including the impact of adding patient age.
Main Results:
- A 'miRNA survival score' was developed from 7 dysregulated miRNAs.
- Patients with high scores exhibited significantly worse prognoses.
- Incorporating patient age into the score substantially increased its predictive accuracy.
Conclusions:
- The study presents the first miRNA-based biomarker score for predicting medical patient outcomes in the ICU.
- Adding patient age to the miRNA score enhances its predictive capability.
- Further research is necessary to validate the clinical utility of this score for risk stratification.
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