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Войти в исследования Respiratory investigation · 2026
Serum soluble ST2: An effective prognostic biomarker for mortality in patients with severe acute exacerbation of chronic obstructive pulmonary disease requiring invasive mechanical ventilation.
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Lv Yunxiang, Huang JianLing, Han Kexing, Gong Beilei, Jiang Guiyun
Аннотация
BACKGROUND: For severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients unresponsive to initial treatment and at high mortality risk, early biomarker-based risk stratification may refine therapies and boost survival.
METHODS: A total of 84 patients with severe AECOPD were prospectively enrolled. Serum soluble ST2 (sST2) levels were measured at baseline (day 0, diagnosis) and on days 3 and 7 after systemic therapy was initiated. The primary goals were to evaluate the prognostic value of sST2 for predicting all-cause in-hospital mortality and to determine its additive predictive effect when integrated with the DECAF score (Dyspnoea, Eosinopenia, Consolidation, Acidaemia, and atrial Fibrillation).
RESULTS: Elevated sST2 levels on days 0, 3, and 7 demonstrated strong predictive value for in-hospital mortality, with area under the receiver operating characteristic curve (AUC) values of 0.799 (95% CI: 0.697-0.878), 0.856 (95% CI: 0.762-0.923), and 0.912 (95% CI: 0.831-0.963), respectively. In univariate Cox regression analysis, patients with higher sST2 levels at these time points exhibited significantly increased 60-day non-survival (hazard ratios [HRs]: 12.4 [95% CI:4.4-35.0], 11.9 [95% CI: 4.4-31.7], and 37.8 [95% CI: 12.7-113.0] for days 0, 3, and 7, respectively; P < 0.001). Multivariate analysis revealed that combining sST2 levels ≥718 pg/mL on day 3 with the DECAF score enhanced mortality prediction accuracy (AUC: 0.920 vs. 0.654 for DECAF alone; P < 0.001 for difference).
CONCLUSIONS: Early serum sST2 levels independently predict mortality in patients with severe AECOPD, and their integration with the DECAF score improves prognostic accuracy.
METHODS: A total of 84 patients with severe AECOPD were prospectively enrolled. Serum soluble ST2 (sST2) levels were measured at baseline (day 0, diagnosis) and on days 3 and 7 after systemic therapy was initiated. The primary goals were to evaluate the prognostic value of sST2 for predicting all-cause in-hospital mortality and to determine its additive predictive effect when integrated with the DECAF score (Dyspnoea, Eosinopenia, Consolidation, Acidaemia, and atrial Fibrillation).
RESULTS: Elevated sST2 levels on days 0, 3, and 7 demonstrated strong predictive value for in-hospital mortality, with area under the receiver operating characteristic curve (AUC) values of 0.799 (95% CI: 0.697-0.878), 0.856 (95% CI: 0.762-0.923), and 0.912 (95% CI: 0.831-0.963), respectively. In univariate Cox regression analysis, patients with higher sST2 levels at these time points exhibited significantly increased 60-day non-survival (hazard ratios [HRs]: 12.4 [95% CI:4.4-35.0], 11.9 [95% CI: 4.4-31.7], and 37.8 [95% CI: 12.7-113.0] for days 0, 3, and 7, respectively; P < 0.001). Multivariate analysis revealed that combining sST2 levels ≥718 pg/mL on day 3 with the DECAF score enhanced mortality prediction accuracy (AUC: 0.920 vs. 0.654 for DECAF alone; P < 0.001 for difference).
CONCLUSIONS: Early serum sST2 levels independently predict mortality in patients with severe AECOPD, and their integration with the DECAF score improves prognostic accuracy.