New study: suPAR cut-offs for stratification of acute medical patients

In this new prospective observational study of acute medical patients, conducted at Mikkeli Hospital in Finland, suPAR was measured using the suPARnostic® Turbilatex assay on a Cobas c501 (Roche DiagnosticsLtd) analyser, allowing for suPAR values along with other biomarkers. Previously suggested cut-offs of suPAR that may indicate low-medium and high risk of 30- and 90-day follow up were tested.

The results how that suPAR provides significant prognostic patient value. Patients with a suPAR level below 4 ng/ml have low risk of 30- and 90-day mortality (less than 1%), whereas 90-day mortality reached above 20% in patients with suPAR above 6 ng/ml. This high negative predictive value in patients with suPAR level below 4 ng/ml can aid in the decision to discharge of patients, in combination with other clinical findings.

Important results:

• suPAR, independently of age, sex and C-reactive protein levels, predicted 30- and 90-day mortality
• Among the 1747 acute medical patients, almost half had a suPAR level below 4 ng/ml, and the 30- and 90-day risk of mortality in these patients was below 1%
• patients with suPAR above 6 ng/ml (1 in 4 patients) had a high 90-daymortality of 20%.

Conclusion

suPAR cut-offs of below 4, between 4-6 and above 6 ng/ml can identify acute medical patients who have low, medium or high risk of 30- and 90-day mortality. A suPAR level below 4ng/ml can thus be useful as a discharge marker. The turbidimetric assay provides fast results that can improve decisions of discharge or admission of acute medical patients.