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  • 1ISG-002 PHARMACIST RISK STRATIFICATION: a characterisation of patients with low soluble urokinase plasminogen activator receptor who died within 90 days of hospital discharge

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Section 1: Introductory statements and governance
1ISG-002 PHARMACIST RISK STRATIFICATION: a characterisation of patients with low soluble urokinase plasminogen activator receptor who died within 90 days of hospital discharge
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  1. LWS Christensen1,2,
  2. E Iversen1,
  3. A Andersen1,
  4. AB Walls3,4,
  5. LJH Rasmussen1,5,
  6. O Andersen1,6,7,
  7. T Kallemose1,
  8. MB Houlind1,2,4
  1. 1Copenhagen University Hospital- Hvidovre, Department of Clinical Research, Hvidovre, Denmark
  2. 2Rerlev Hospital, The Capital Region Pharmacy, Herlev, Denmark
  3. 3Rigshospitalet- Copenhagen, The Capital Region Hospital Pharmacy, Copenhagen, Denmark
  4. 4University of Copenhagen, Department of Drug Design and Pharmacology, Copenhagen, Denmark
  5. 5Duke University- Durham, Department of Psychology and Neuroscience, North Carolina, USA
  6. 6University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark
  7. 7Copenhagen University Hospital- Hvidovre, Emergency department, Hvidovre, Denmark

Abstract

Background and Importance Soluble urokinase plasminogen activator receptor (suPAR) is a marker of systemic chronic inflammation thought to reflect overall disease burden. suPAR has been suggested as a prognostic marker in clinical settings, since elevated suPAR levels are strongly associated with mortality. Researchers have suggested using a suPAR level <3 ng/mL for safe and early discharge from the emergency department (ED). However, a subset of patients with low suPAR dies within 90 days of hospital discharge, and the risk is significantly associated with an increased medication use.

Aim and Objectives The aim of the present study was to characterise patients with low suPAR (<3 ng/mL) who died within 90 days of hospital discharge by exploring factors other than suPAR that may explain this contradictory finding of mortality among patients with low suPAR.

Material and Methods This observational registry-based study included consecutively admitted medical patients to the ED at our hospital from November 2013 to March 2017. We used validated databases and national registries to describe patients’ characteristics (age, medication use, diagnoses, frailty index).

Results Compared to patients with low suPAR who survived (n=15,122), those who died within 90 days (n=87) had higher age (75.4 years), medication use (7.0; 71.3% with polypharmacy), more blood tests outside reference intervals (5.0) (including C-reactive protein, neutrophils, albumin), and the most common diagnoses were chronic pulmonary disease (27.6%), cerebrovascular disease (18.4%), and dementia (11.5%). The most common medications were antithrombotic agents (44.8%), lipid modifying agents (plain) (39.1%), and other analgesics and antipyretics (33.3%).

Conclusion and Relevance Patients with low suPAR who died had other risk factors explaining their morbidity and mortality risk than what was reflected by their suPAR level. Using suPAR as a proxy for disease burden in clinical settings may be challenging in situations, where patients receive a high number of medications. We suggest including medication use, routine blood tests, and selected diagnosis codes in combination with suPAR when stratifying patients based on their risk of adverse clinical outcomes.

Conflict of Interest No conflict of interest.

https://doi.org/10.1136/ejhpharm-2024-eahp.14

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