Prognostic and diagnostic capabilities of a biomarker are ‘two sides of the same coin’ in medicine. For instance, serum troponin is very useful in diagnosing acute myocardial infarction and, at the same time, the peak concentrations of serum troponin are also useful in assessing the prognosis of both ST-elevation myocardial infarction (STEMI) and non-STEMI1. In this issue of the Journal, we have two interesting studies on prognostic significance of serum C-reactive protein (CRP) or lactate concentrations in critically ill patients2,3, and they conclude that these non-specific biomarkers may be useful to predict mortality of critically ill patients.
References
1.
ThielmannM., MassoudyP., NeuhäuserM., TsagakisK., MarggrafG., KamlerM.Prognostic value of preoperative cardiac troponin I in patients undergoing emergency coronary artery bypass surgery with non-ST-elevation or ST-elevation acute coronary syndromes.Circulation2006; 114(1 Suppl): 1448–1453.
2.
KangY.R., UmS-W, KohW-J, SuhG.Y., ChungM.P., KimH.Initial lactate level and mortality in septic shock patients with hepatic dysfunction.Anaesth Intensive Care2011; 39: 5: 862–867.
3.
ZhangZ., NiH.C-reactive protein as a predictor of mortality in critically ill patients: a meta-analysis and systematic review.Anaesth Intensive Care2011; 39: 5: 854–861.
4.
HoK.M., LipmanJ.An update on C-reactive protein for intensivists.Anaesth Intensive Care2009; 37: 234–241.
5.
HoK.M., LeeK.Y., DobbG.J., WebbS.A.C-reactive protein concentration as a predictor of in-hospital mortality after ICU discharge: a prospective cohort study.Intensive Care Med2008; 34: 481–487.
6.
HoK.M., LeonardA.D.Concentration-dependent effect of hypocalcaemia on mortality of patients with critical bleeding requiring massive transfusion: a cohort study.Anaesth Intensive Care2011; 39: 46–54.
7.
HoK.M., KnuimanM., FinnJ., WebbS.A.Estimating long-term survival of critically ill patients: the PREDICT model.PLoS One2008; 3: e3226.
8.
WibrowB.A., HoK.M., FlexmanJ.P., KeilA.D., KohrsD.L.Eosinopenia as a diagnostic marker of bloodstream infection in hospitalised paediatric and adult patients: a case-control study.Anaesth Intensive Care2011; 39: 224–230.
9.
HoK.M., TanJ.A.Benefits and risks of corticosteroid prophylaxis in adult cardiac surgery: a dose-response meta-analysis.Circulation2009; 119: 1853–1866.
10.
HoK.M.Hyperlactataemia induced by CVVHDF with low lactate bicarbonate-buffered solutions in patients with liver dysfunction.Nephrol Dial Transplant2006; 21: 1096–1099.
