186
Views
1
CrossRef citations to date
0
Altmetric
Reviews

Prognostic association of routinely measured biomarkers in patients admitted to critical care: a systematic review

ORCID Icon, ORCID Icon, ORCID Icon, ORCID Icon & ORCID Icon
Pages 1-12 | Received 29 Jul 2020, Accepted 18 Oct 2020, Published online: 05 Nov 2020
 

Abstract

Purpose

To examine reported prognostic associations of routine blood measurements in the intensive care unit.

Materials and methods

We searched PubMed, EMBASE through 28th May 2020 to identify all studies in adult critical care investigating associations between parameters measured routinely in whole blood, plasma or serum, and length of stay or mortality. Registration: PROSPERO; CRD42019122058.

Results

A total of 128 studies, reporting 28 different putative prognostic biomarkers, met eligibility criteria. Those most frequently examined were red cell distribution width, neutrophil-to-lymphocyte ratio, C-reactive protein, and platelet count. A higher red cell distribution width, a lower platelet count, and a higher neutrophil-to-lymphocyte ratio were consistently associated with both increased mortality and length of stay. A lower level of albumin was consistently associated with greater mortality. C-reactive protein was inconsistent. Most studies (n = 110) used regression modelling with wide variation in variable selection and covariate-adjustment; none externally validated the proposed predictive models.

Conclusions

Simple regression models have so far proved inadequate for the complexity of data available from routine blood sampling in critical care. Adoption of a direct causal framework may help better assess mechanistic processes, aid design of future studies, and guide clinical decision making using routine data.

Author contributions

All authors reviewed and approved the final manuscript. YW and JP were responsible for the study concept and YW, RH, and JP for study design. Data extraction and analysis was undertaken by YW, AB, and RH. YW, RH, ZP, and JP wrote the manuscript.

Disclosure statement

The authors report no declarations of interest.

Correction Statement

This article has been republished with minor change. This change do not impact the academic content of the article.

Log in via your institution

Log in to Taylor & Francis Online

PDF download + Online access

  • 48 hours access to article PDF & online version
  • Article PDF can be downloaded
  • Article PDF can be printed
USD 65.00 Add to cart

Issue Purchase

  • 30 days online access to complete issue
  • Article PDFs can be downloaded
  • Article PDFs can be printed
USD 527.00 Add to cart

* Local tax will be added as applicable

Related Research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.