Plasma sRAGE is independently associated with increased mortality in ARDS: a meta-analysis of individual patient data

dc.contributor.authorMatthieu Jabaudonen_US
dc.contributor.authorRaiko Blondonneten_US
dc.contributor.authorBruno Pereiraen_US
dc.contributor.authorRodrigo Cartin-Cebaen_US
dc.contributor.authorChristoph Lichtensternen_US
dc.contributor.authorTommaso Maurien_US
dc.contributor.authorRogier M. Determannen_US
dc.contributor.authorTomas Drabeken_US
dc.contributor.authorRolf D. Hubmayren_US
dc.contributor.authorOgnjen Gajicen_US
dc.contributor.authorFlorian Uhleen_US
dc.contributor.authorAndrea Coppadoroen_US
dc.contributor.authorAntonio Pesentien_US
dc.contributor.authorMarcus J. Schultzen_US
dc.contributor.authorMarco V. Ranierien_US
dc.contributor.authorHelena Brodskaen_US
dc.contributor.authorSégolène Mrozeken_US
dc.contributor.authorVincent Sapinen_US
dc.contributor.authorMichael A. Matthayen_US
dc.contributor.authorJean Michel Constantinen_US
dc.contributor.authorCarolyn S. Calfeeen_US
dc.contributor.otherV eobecná Fakultní Nemocnice V Prazeen_US
dc.contributor.otherUniversità degli Studi di Milanoen_US
dc.contributor.otherCHU de Toulouseen_US
dc.contributor.otherUniversity of California, San Franciscoen_US
dc.contributor.otherOur Lady Hospital - Amsterdamen_US
dc.contributor.otherAzienda Ospedaliera San Gerardo Monzaen_US
dc.contributor.otherMahidol Universityen_US
dc.contributor.otherUniversità degli Studi di Torinoen_US
dc.contributor.otherCentre Hospitalier Universitaire de Clermont-Ferranden_US
dc.contributor.otherMayo Clinicen_US
dc.contributor.otherUniversite d' Auvergne Clermont-FD 1en_US
dc.contributor.otherUniversitätsklinikum Heidelbergen_US
dc.contributor.otherUniversity of Pittsburgh School of Medicineen_US
dc.contributor.otherAmsterdam UMC - University of Amsterdamen_US
dc.description.abstract© 2018, The Author(s). Purpose: The soluble receptor for advanced glycation end-products (sRAGE) is a marker of lung epithelial injury and alveolar fluid clearance (AFC), with promising values for assessing prognosis and lung injury severity in acute respiratory distress syndrome (ARDS). Because AFC is impaired in most patients with ARDS and is associated with higher mortality, we hypothesized that baseline plasma sRAGE would predict mortality, independently of two key mediators of ventilator-induced lung injury. Methods: We conducted a meta-analysis of individual data from 746 patients enrolled in eight prospective randomized and observational studies in which plasma sRAGE was measured in ARDS articles published through March 2016. The primary outcome was 90-day mortality. Using multivariate and mediation analyses, we tested the association between baseline plasma sRAGE and mortality, independently of driving pressure and tidal volume. Results: Higher baseline plasma sRAGE [odds ratio (OR) for each one-log increment, 1.18; 95% confidence interval (CI) 1.01–1.38; P = 0.04], driving pressure (OR for each one-point increment, 1.04; 95% CI 1.02–1.07; P = 0.002), and tidal volume (OR for each one-log increment, 1.98; 95% CI 1.07–3.64; P = 0.03) were independently associated with higher 90-day mortality in multivariate analysis. Baseline plasma sRAGE mediated a small fraction of the effect of higher ΔP on mortality but not that of higher VT. Conclusions: Higher baseline plasma sRAGE was associated with higher 90-day mortality in patients with ARDS, independently of driving pressure and tidal volume, thus reinforcing the likely contribution of alveolar epithelial injury as an important prognostic factor in ARDS. Registration: PROSPERO (ID: CRD42018100241).en_US
dc.identifier.citationIntensive Care Medicine. Vol.44, No.9 (2018), 1388-1399en_US
dc.rightsMahidol Universityen_US
dc.titlePlasma sRAGE is independently associated with increased mortality in ARDS: a meta-analysis of individual patient dataen_US