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Serum phospholipase A2 in patients with multiple organ failure
K M Nyman1, W Uhl, J Forsström
1Department of Pathology, University of Turku, Finland.
The Journal of Surgical Research
|January 1, 1996
Summary
Group II phospholipase A2 (PLA2) serum levels effectively predict lethal multiple organ failure (MOF) in surgical patients. Elevated PLA2 indicates severe infection and serves as a crucial diagnostic marker.
Area of Science:
- Biochemistry
- Critical Care Medicine
- Surgical Pathology
Background:
- Multiple organ failure (MOF) is a leading cause of mortality in surgical intensive care units.
- Understanding early predictors of MOF is crucial for improving patient outcomes.
- Group II phospholipase A2 (PLA2) is implicated in inflammatory processes.
Purpose of the Study:
- To investigate the relationship between serum group II PLA2 concentrations and the development of MOF in surgical patients.
- To evaluate the diagnostic and prognostic utility of group II PLA2 in severe infections and MOF.
Main Methods:
- Prospective study of 215 surgical intensive care patients (multiple injuries, peritonitis, sepsis) and controls.
- Measurement of serum group II PLA2 and C-reactive protein (CRP) levels.
- Utilized receiver operating characteristic (ROC) curves to assess clinical performance.
Main Results:
- Serum group II PLA2 levels were elevated in all patient groups during the first week.
- Significantly higher PLA2 levels were observed in patients with severe infections (peritonitis, sepsis) compared to others (ROC 0.931, P < 0.0001).
- Group II PLA2 correlated positively with CRP and body temperature, identifying it as an acute phase reactant.
Conclusions:
- Serum group II PLA2 is a valuable marker for diagnosing severe infections.
- Elevated group II PLA2 effectively predicts lethal MOF in patients with multiple injuries (after day 2, ROC 0.739) and peritonitis (after day 4, ROC 0.750).