8f09ae842f8cec418fb9ac57ada7f9dc pmc_10604889.pdf 9073afa7cefcb4d1c1a09ed57d7b68af0628d53b pmc_10604889.pdf 0e7243470e594d9d1e5e9a8676a04c75433e909f3b78d8cfc1716caaeb472b0a pmc_10604889.pdf Title: Evaluation of the Kinetics of Pancreatic Stone Protein as a Predictor of Ventilator-Associated Pneumonia Subject: BACKGROUND: Ventilator-associated pneumonia (VAP) is a severe condition. Early and adequate antibiotic treatment is the most important strategy for improving prognosis. Pancreatic Stone Protein (PSP) has been described as a biomarker that increases values 3–4 days before the clinical diagnosis of nosocomial sepsis in different clinical settings. We hypothesized that serial measures of PSP and its kinetics allow for an early diagnosis of VAP. METHODS: The BioVAP study was a prospective observational study designed to evaluate the role of biomarker dynamics in the diagnosis of VAP. To determine the association between repeatedly measured PSP and the risk of VAP, we used joint models for longitudinal and time-to-event data. RESULTS: Of 209 patients, 43 (20.6%) patients developed VAP, with a median time of 4 days. Multivariate joint models with PSP, CRP, and PCT did not show an association between biomarkers and VAP for the daily absolute value, with a hazard ratio (HR) for PSP of 1.01 (95% credible interval: 0.97 to 1.05), for CRP of 1.00 (0.83 to 1.22), and for PCT of 0.95 (0.82 to 1.08). The daily change of biomarkers provided similar results, with an HR for PSP of 1.15 (0.94 to 1.41), for CRP of 0.76 (0.35 to 1.58), and for PCT of 0.77 (0.40 to 1.45). CONCLUSION: Neither absolute PSP values nor PSP kinetics alone nor in combination with other biomarkers were useful in improving the prediction diagnosis accuracy in patients with VAP. Clinical Trial Registration: Registered retrospectively on August 3rd, 2012. NCT02078999. Keywords: ventilator-associated pneumonia; pancreatic stone protein; biomarkers; prediction Author: Adrian Ceccato, Marta Camprubí-Rimblas, Lieuwe D. J. Bos, Pedro Povoa, Ignacio Martin-Loeches, Carles Forné, Aina Areny-Balagueró, Elena Campaña-Duel, Luis Morales-Quinteros, Sara Quero, Paula Ramirez, Mariano Esperatti, Antoni Torres, Lluis Blanch and Antonio Artigas Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Oct 9 09:41:36 2023 CEST ModDate: Mon Oct 9 09:48:14 2023 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1487390 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- ZULHMF+VnURWPalladioL Type 1 Custom yes yes no 10 0 FGFAZA+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 TGLOCV+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 SPMBYE+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 XWOCXD+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 EBFBTV+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 OHXQCJ+CMSY10 Type 1 Builtin yes yes no 71 0 BDOANN+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 85 0 BDOCOK+Cambria CID TrueType Identity-H yes yes yes 91 0 BDOAOO+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 97 0 BDOAOP+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 103 0 BDOBAA+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 109 0 BDOBAB+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 112 0 BDOBAC+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 115 0 BDOCEM+PalatinoLinotype-Roman TrueType MacRoman yes yes no 118 0 BDOANN+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 135 0 BDOAOO+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 141 0 BDOAOP+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 147 0 BDOBAA+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 153 0 BDOBAB+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 156 0 BDOBAC+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 159 0 BDOCEM+PalatinoLinotype-Roman TrueType MacRoman yes yes no 162 0 BDOANN+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 181 0 BDOAOO+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 187 0 BDOAOP+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 193 0 BDOBAA+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 199 0 BDOBAB+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 202 0 BDOBAC+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 205 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-11-18 02:42:10 CET RepresentationInformation: pmc_10604889.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-11-09 02:18:58 CET Size: 1487390 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 357 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@4d3167f4 Item: Title: Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@ed9d034 Children: Item: Title: Inclusion and Exclusion Criteria Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@6121c9d6 Item: Title: Measurement of PSP Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@87f383f Item: Title: Definitions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@4eb7f003 Item: Title: Outcomes Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@eafc191 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@612fc6eb Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1060b431 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@612679d6 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@11758f2a Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@e720b71 Info: Title: Evaluation of the Kinetics of Pancreatic Stone Protein as a Predictor of Ventilator-Associated Pneumonia Author: Adrian Ceccato, Marta Camprubí-Rimblas, Lieuwe D. J. Bos, Pedro Povoa, Ignacio Martin-Loeches, Carles Forné, Aina Areny-Balagueró, Elena Campaña-Duel, Luis Morales-Quinteros, Sara Quero, Paula Ramirez, Mariano Esperatti, Antoni Torres, Lluis Blanch and Antonio Artigas Subject: BACKGROUND: Ventilator-associated pneumonia (VAP) is a severe condition. Early and adequate antibiotic treatment is the most important strategy for improving prognosis. Pancreatic Stone Protein (PSP) has been described as a biomarker that increases values 3 4 days before the clinical diagnosis of nosocomial sepsis in different clinical settings. We hypothesized that serial measures of PSP and its kinetics allow for an early diagnosis of VAP. METHODS: The BioVAP study was a prospective observational study designed to evaluate the role of biomarker dynamics in the diagnosis of VAP. To determine the association between repeatedly measured PSP and the risk of VAP, we used joint models for longitudinal and time-to-event data. RESULTS: Of 209 patients, 43 (20.6%) patients developed VAP, with a median time of 4 days. Multivariate joint models with PSP, CRP, and PCT did not show an association between biomarkers and VAP for the daily absolute value, with a hazard ratio (HR) for PSP of 1.01 (95% credible interval: 0.97 to 1.05), for CRP of 1.00 (0.83 to 1.22), and for PCT of 0.95 (0.82 to 1.08). The daily change of biomarkers provided similar results, with an HR for PSP of 1.15 (0.94 to 1.41), for CRP of 0.76 (0.35 to 1.58), and for PCT of 0.77 (0.40 to 1.45). CONCLUSION: Neither absolute PSP values nor PSP kinetics alone nor in combination with other biomarkers were useful in improving the prediction diagnosis accuracy in patients with VAP. Clinical Trial Registration: Registered retrospectively on August 3rd, 2012. NCT02078999. 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