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Do biomarkers add anything to clinical prediction of mortality in older medical emergency department patients?

  • Noortje Zelis
    Correspondence
    Corresponding author at: Maastricht University Medical Centre+, Department of Internal Medicine, Division of General Internal Medicine, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
    Affiliations
    Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre, The Netherlands

    Department of Internal Medicine, Division of General Internal Medicine, Section Acute Medicine, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands
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  • Jacqueline Buijs
    Affiliations
    Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre, The Netherlands
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  • Peter W. de Leeuw
    Affiliations
    Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre, The Netherlands

    Department of Internal Medicine, Division of General Internal Medicine, Section Acute Medicine, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands

    CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands
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  • Patricia M. Stassen
    Affiliations
    Department of Internal Medicine, Division of General Internal Medicine, Section Acute Medicine, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands

    CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands
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  • on behalf of the
    Affiliations
    School of CAPHRI, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands
  • Author Footnotes
    1 Additional collaborators: Sander M.J. van Kuijk, PhD, Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht University, Maastricht, the Netherlands, Robin Hundscheid, MD, Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre, Geleen/Heerlen, the Netherlands and Maarten T.M. Raijmakers, PhD2, Laboratory of Clinical Chemistry and Haematology, Zuyderland Medical Centre, Geleen/Heerlen, The Netherlands.
      Recently, we described in this Journal a simplified, yet accurate clinical decision model (the RISE UP score) to predict 30-day mortality in older patients who visit an emergency department [
      • Zelis N.
      • Buijs J.
      • de Leeuw P.W.
      • van Kuijk S.M.J.
      • Stassen P.M.
      A new simplified model for predicting 30-day mortality in older medical emergency department patients: the rise up score.
      ]. Although several studies have shown that certain biomarkers are good predictors of outcome as well, it remains enigmatic whether these have any additional value over and above clinical decision rules such as ours. This is particularly true for the elderly population. As part of the RISE UP study, we also collected blood for determination of several biomarkers from the patients who participated in this study. This allowed us to hypothesize that the already high discriminatory value of our clinical model might improve even further when these biomarkers would be added to the score. The markers that we tested were arterial lactate, hs-cTnT, NT-proBNP, D-dimer and procalcitonin (PCT).
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