Prognostic value of hyperuricemia for patients with sepsis in the intensive care unit

Liu, Shizhen; Zhong, Zhihua; Liu, Fanna

doi:10.1038/s41598-022-04862-3

Cited by 12 publications

(13 citation statements)

References 58 publications

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“…Interestingly, hyperuricemia contributed to the elevation of fatality risk in non-neonatal listeriosis. Previous reports revealed that hyperuricemia was associated with increased risk of 90-day all-cause mortality and the incidence of acute kidney injury in patients with sepsis [ 48 ]. High uric acid levels were also associated with adverse outcomes in patients hospitalized for coronavirus disease 2019 [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Fatality Risk Factors for Patients with Listeria monocytogenes Infection: A 12-Year Hospital-Based Study in Xi’an, China

Xu,

Peng,

et al. 2024

Infect Dis Ther

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Introduction Listeriosis is a severe food-borne disease caused by Listeria monocytogenes infection. The data of listeriosis in Xi’an population are limited. The aim of this study is to evaluate the clinical features and fatality risk factors for listeriosis in three tertiary-care hospitals in Xi’an, China Methods The characteristics of demographic data, underlying diseases, clinical manifestations, laboratory indicators, cranial imaging examination, antibiotics therapeutic schemes, and clinical outcomes were collected between 2011 and 2023. Logistic regression analysis was performed. Results Seventy-one etiologically confirmed listeriosis patients were enrolled, including 12 neonatal and 59 non-neonatal cases. The majority of neonatal listeriosis presented as preterm (50%) and fetal distress (75%). The main clinical manifestations of non-neonatal listeriosis included fever (88%), headache (32%), disorder of consciousness (25%), vomiting (17%), abdominal pain (12%), and convulsions (8%). The fatality rate in neonatal cases was higher than in non-neonatal listeriosis (42 vs. 17%). Although no deaths were reported in maternal listeriosis, only two of 23 patients had an uneventful obstetrical outcome. Five maternal listeriosis delivered culture-positive neonates, three of whom decreased within 1 week post-gestation due to severe complications. Twenty-eight cases were neurolisteriosis and 43 cases were bacteremia. Neurolisteriosis had a higher fatality rate compared with bacteremia listeriosis (36 vs. 12%). The main neuroradiological images were cerebral edema/hydrocephalus, intracranial infection, and cerebral hernia. Listeria monocytogenes showed extremely low resistance to ampicillin (two isolates) and penicillin (one isolate). The fatality risk factors were the involvement of the central nervous system, hyperbilirubinemia, and hyponatremia for all enrolled subjects. Hyperuricemia contributed to the elevation of fatality risk in non-neonatal listeriosis. Conclusions When the patients suffered with symptoms of fever and central nervous system infection, they should be alert to the possibility of listeriosis. Early administration of ampicillin- or penicillin-based therapy might be beneficial for recovery of listeriosis.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Fatality Risk Factors for Patients with Listeria monocytogenes Infection: A 12-Year Hospital-Based Study in Xi’an, China

Xu,

Peng,

et al. 2024

Infect Dis Ther

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“…Some of the papers that have been reported have produced conflicting results. Many reports that hyperuricemia is associated with sepsis [ 43 , 44 , 45 , 46 ], sepsis-induced ARDS [ 47 ], AKI prognosis [ 48 ], prolonged hospital stay [ 43 ], or that uric acid increases over time [ 49 ]. On the contrary, some reports suggest that hypouricemia may be a poor prognostic factor for sepsis or sepsis-associated ARDS [ 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Significance of Elevated Xanthine Dehydrogenase Levels and Hyperuricemia in Patients with Sepsis

Matsuoka,

Yamaguchi,

Kinoshita

2023

IJMS

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Patient outcomes for severe sepsis and septic shock remain poor. Excessive oxidative stress accelerates organ dysfunction in severe acute illnesses. Uric acid (UA) is the most abundant antioxidant. We hypothesized that UA and related molecules, which play a critical role in antioxidant activity, might be markers of oxidative stress in sepsis. The study aimed to clarify the clinical significance of UA and the relationship between UA, molecules related to UA, and outcomes by measuring blood UA, xanthine dehydrogenase (XDH), and 8-hydroxy-2-deoxyguanosine (8-OHdG) levels over time. Blood UA levels in septic patients were correlated with the SOFA score (ρ = 0.36, p < 0.0001) and blood XDH levels (ρ = 0.27, p < 0.0001). Blood XDH levels were correlated with the SOFA score (ρ = 0.59, p < 0.0001) and blood 8-OHdG levels (ρ = −0.32, p < 0.0001). Blood XDH levels were persistently high in fatal cases. Blood XDH level (OR 8.84, 95% CI: 1.42–91.2, p = 0.018) was an independent factor of poor outcomes. The cutoff of blood XDH level was 1.38 ng/mL (sensitivity 92.8%, specificity 61.9%), and those 1.38 ng/mL or higher were associated with a significantly reduced survival rate (blood XDH level > 1.38 ng/mL: 23.7%, blood XDH level < 1.38 ng/mL: 96.3%, respectively, p = 0.0007). Elevated UA levels due to elevated blood XDH levels in sepsis cases may reduce oxidative stress. Countermeasures against increased oxidative stress in sepsis may provide new therapeutic strategies.

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“…There are similar relationships between serum UA levels and infectious diseases. The study by Liu et al in 954 ICU patients with sepsis showed that high UA level was associated with mortality (HR: 1.65) and AKI (HR:1.77) (15). In a study conducted on ICU patients with sepsis, UA levels were higher in patients with acute respiratory distress syndrome (ARDS) and who died.…”

Section: Mid Blac Sea J Health Scimentioning

confidence: 99%

Effects of Uric Acid on Disease Severity and Mortality in Hospitalized Covid-19 Patients

Türkmen

Karataş

Güllü

2022

Middle Black Sea Journal of Health Science

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Background: High and low uric acid (UA) levels in the general population are associated with mortality. Information on the association of UA levels with clinical outcomes in COVID-19 patients is contradictory. We investigated the relationship between UA levels and clinical endpoints in COVID-19 patients. Methods: Laboratory and clinical parameters, including UA at the admission of hospitalized COVID-19 patients, were recorded retrospectively. Binary logistic regression analysis determined risk factors for mortality and the intensive care unit (ICU) needs. Results: This study included 708 patients (57.1% men), and the median age was 63 (18-98) years. Two hundred and three (28.7%) patients needed ICU, and 107 (15.7%) died. Uric acid levels were significantly higher in the deceased (6.5 vs. 4.9; pmedian value 5.1 mg/dL) group have higher mortality rate (22.4% vs. 9.5%; p

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Prognostic value of hyperuricemia for patients with sepsis in the intensive care unit

Cited by 12 publications

References 58 publications

Clinical Characteristics and Fatality Risk Factors for Patients with Listeria monocytogenes Infection: A 12-Year Hospital-Based Study in Xi’an, China

Clinical Characteristics and Fatality Risk Factors for Patients with Listeria monocytogenes Infection: A 12-Year Hospital-Based Study in Xi’an, China

Clinical Significance of Elevated Xanthine Dehydrogenase Levels and Hyperuricemia in Patients with Sepsis

Effects of Uric Acid on Disease Severity and Mortality in Hospitalized Covid-19 Patients

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