ViroGates A/S : Clinical role of suPAR in the prognosis of patients in the emergency setting and its influence on risk stratification

Background: Numerous observational studies and clinical trials have been conducted to assess the role of suPAR in emergency department (ED) outcomes (19-23). However, as of the current date, no pooled results or quantitative synthesis have been performed. In this study, a meta-analysis was conducted to explore available data on ED outcomes, including 30-day mortality, 90-day mortality, readmission within 30 days, discharge within 24 hours, and length of hospital stay (LOS). The aim was to draw conclusive results and determine the clinical role of suPAR, as an evolving biomarker, in the prognosis of patients in the emergency setting and its influence on risk stratification.

Methods: A comprehensive search was conducted on six databases from inception to November 30, 2022, to select studies meeting the following eligibility criteria: a) observation or triage trial studies investigating the role of suPAR levels in predicting 30-day and 90-day mortality, 30-day readmission, early discharge (within 24 hours), and length of stay (LOS) in patients coming to the Acute Medical Unit (AMU).

Discussion: Despite frequent research on examining the impact of suPAR concentrations on patients admitted to the ED department, no meta-analysis has been conducted to explore this association until now. Thus, the first-ever meta-analysis was conducted to examine the impact of suPAR levels as a biomarker in patients admitted under acute care. Increased risk by 10.52 (P < .00001), 5.76 (P < .00001), 1.50 (P = .002), and 2.82 (P < .0001) times in 30 and 90-day mortality, 30-day readmission, and length of hospital stay, respectively, was associated with high suPAR concentrations. It was also revealed through the analysis that high suPAR concentration was associated with lesser rates of discharge from the hospital within 24 hours (P < .00001).

Conclusion: The paper not only confirms but also contributes with new knowledge of suPAR as an independent predictor of length of hospital stay and discharge within 24 hours. In the analysis, 2.82 times increase in the length of hospital stay among high suPAR patients under acute care was observed. High suPAR level at admission to ED is a sign of a serious condition and is attributed to higher risks of mortality and readmission.