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Plasma chromogranin A after severe burn trauma
Department of Surgical Sciences, Uppsala University.
Department of Surgical Sciences, Uppsala University.
Department of Medical Sciences, Uppsala University.
Linköping University, Department of Clinical and Experimental Medicine, Burn Center. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Surgery.
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2013 (English)In: Neuropeptides, ISSN 0143-4179, E-ISSN 1532-2785, Vol. 47, no 3, 207-212 p.Article in journal (Refereed) Published
Abstract [en]

Background: Chromogranin A (CgA) in plasma (P-CgA), a neuroendocrine marker of sympathetic stress, has been shown to predict mortality in medical intensive care. We hypothesized that the magnitude of CgA release would reflect stress load, and thereby injury severity in burn intensive care patients. Methods: Fifty-one consecutive patients with a burn area exceeding 10% were included. P-CgA was measured twice daily for seven days after injury. The point value at 24 h, the mean and maximum values and the AUC at days 1-7, were tested as possible predictors. Injury severity in the form of organ dysfunction was measured as SOFA score at day 7. Results: P-CgA could be classified into two types with respect to variability over time. Patients with high variability had more deep injuries and were older than those with low variability. All measures of CgA correlated with SOFA score at day 7, but not with total burn size. Univariate regressions showed that age, burn size and three of four measures of P-CgA predicted organ dysfunction. Multiple regressions showed that age, burn size, and either P-CgA at 24 h, the mean value up to day 7, or the maximum value up to day 7, were independent predictors for organ dysfunction. Significant organ dysfunction was best predicted by age, burn area and the CgA point value at 24 h with an AUC value of 0.91 in a ROC-analysis. Conclusions: The extent of neuroendocrine activation assessed as P-CgA after a major burn injury is independently related to organ dysfunction.

Place, publisher, year, edition, pages
Elsevier, 2013. Vol. 47, no 3, 207-212 p.
Keyword [en]
Chromogranin A, Stress, Physiological, Burns, Critical care, Multiple organ failure
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-90363DOI: 10.1016/j.npep.2012.10.004ISI: 000320751200010PubMedID: 23206950OAI: oai:DiVA.org:liu-90363DiVA: diva2:612835
Available from: 2013-03-25 Created: 2013-03-25 Last updated: 2017-12-06

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Sjöberg, Folke

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Burn CenterFaculty of Health SciencesDepartment of Hand and Plastic SurgeryDepartment of Anaesthesiology and Surgery
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