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Table 2 Performance of cardiovascular biomarkers measured at ICU discharge for the prediction of 1-year post-ICU survival

From: Determinants of long-term outcome in ICU survivors: results from the FROG-ICU study

 

NT-proBNP (pg/ml)

hs-TnI (pg/ml)

bio-ADM (pg/ml)

sST2 (ng/ml)

Normal value

< 300

< 14

< 43

< 23.6 for men/< 16.0 for women

Missing data (%)

 Median (IQR) at discharge

  All patients (n = 1570)

541 (149; 2073)

11.2 (4.2; 39.2)

33.3 (20.2; 60.5)

122.2 (73.1; 208.8)

  1-year survivor (n = 1237)

464 (127; 1681)

9.7 (3.7; 33.8)

30.5 (18.7; 52.3)

112.5 (67.9; 188.6)

  1-year nonsurvivor (n = 333)

1471 (371; 5719)

18.5 (7.6; 74.7)

50.4 (28.5; 107.9)

189.1 (102.4; 301.2)

 Association with prognosis (OR (95% CI) of biomarker > median)

  Univariate analysis

2.50 (1.85–3.38)

2.03 (1.51–2.73)

2.52 (1.86–3.42)

2.44 (1.81–3.30)

  Multivariable analysis

2.05 (1.33–3.18)

1.41 (0.94–2.13)

1.61 (1.06–2.45)

1.53 (1.01–2.33)

 AUC of ROC curve (95% CI)

  Biomarker alone

0.659 (0.619–0.699)*

0.625 (0.588–0.663)*

0.672 (0.635–0.711)*

0.657 (0.618–0.697)*

  Biomarker + clinical score

0.794 (0.766–0.823)**

0.789 (0.759–0.817)

0.794 (0.766–0.822)

0.800 (0.773–0.827)**

 NRI of biomarkers added to the full clinical model

  % Events to higher risk

44.3

37.4

43.4

42.5

  % Nonevents to higher risk

14.8

16.1

15.7

17.2

  % Events to lower risk

55.7

62.6

56.6

57.5

  % Nonevents to lower risk

85.2

83.9

84.3

82.8

  Total NRI for events (95% CI)

−0.115 (−0.263 to 0.033)

−0.253 (−0.397 to −0.109)

−0.133 (−0.281 to 0.015)

−0.149 (−0.296 to −0.003)

  Total NRI for nonevents (95% CI)

0.705 (0.650–0.759)

0.678 (0.622–0.734)

0.686 (0.631–0.742)

0.656 (0.598–0.714)

  Total cNRI (95% CI)

0.590 (0.433–0.747)

0.425 (0.271–0.580)

0.554 (0.396–0.711)

0.507 (0.349–0.664)

 IDI of biomarkers added to the full clinical model

  Events to higher risk

0.014

–0.009

0.018

0.005

  Nonevents to lower risk

0.023

0.016

0.024

0.02

  Total (95% CI)

0.036 (0.019–0.054)

0.007 (0–0.014)

0.041 (0.023–0.06)

0.024 (0.009–0.04)

  1. NT-proBNP N-terminal pro-B type natriuretic peptide, hs-TnI hyper-sensitive troponin I, bio-ADM bio-adrenomedullin, sST2 soluble ST2, IQR interquartile range, AUC area under the curve, OR odds ratio, ROC receiver operating curve, CI confidence interval, NRI net reclassification improvement, IDI integrative discrimination improvement
  2. *p < 0.05 corresponding to Wilcoxon test comparing survivors to nonsurvivors
  3. **p < 0.05 corresponding to DeLong test comparing c-statistics of multivariate clinical model without (see Fig. 2) and with inclusion of the biomarker