Table 3.
Neutrophil Extracellular Trap Formation Is an Independent Predictor of Disseminated Intravascular Coagulation and Mortality in Critically Ill Patients
| Crude Odds Ratio | P Value* | Adjusted Odds Ratio (APACHE II) | P Value† | AUC | P Value‡ | |
|---|---|---|---|---|---|---|
| DIC | ||||||
| Absent NET formation | Reference | — | Reference | — | — | — |
| Mild NET formation | 0.274 (0.045–1.677) | 0.161 | 0.248 (0.039–1.560) | 0.137 | — | — |
| Moderate NET formation | 8.121 (2.143–30.770) | 0.002 | 7.176 (1.765–29.177) | 0.006 | — | — |
| Strong NET formation | 14.517 (3.759–56.057) | <0.0001 | 13.035 (3.157–53.829) | <0.0001 | — | — |
| NETs (%) | 1.059 (1.041–1.078) | <0.0001 | 1.058 (1.039–1.078) | <0.0001 | 0.851 | <0.0001 |
| cfDNA | 1.001 (1.000–1.001) | 0.060 | 1.001 (1.000–1.001) | 0.118 | 0.607 | 0.324 |
| MPO | 1.001 (0.997–1.004) | 0.664 | 1.001 (0.997–1.005) | 0.689 | 0.609 | 0.236 |
| DNA–MPO complex | 17.428 (1.976–153.679) | 0.010 | 9.780 (0.972–98.424) | 0.053 | 0.713 | 0.013 |
| IL-1β | 0.993 (0.923–1.068) | 0.845 | 0.999 (0.920–1.084) | 0.973 | 0.588 | 0.272 |
| IL-6 | 1.000 (1.000–1.000) | 0.113 | 1.000 (1.000–1.000) | 0.139 | 0.546 | 0.499 |
| TNF-α | 0.999 (0.994–1.003) | 0.501 | 0.999 (0.995–1.003) | 0.593 | 0.658 | 0.044 |
| IL-8 | 1.000 (1.000–1.000) | 0.049 | 1.000 (1.000–1.001) | 0.083 | 0.666 | 0.002 |
| APACHE II score | 1.144 (1.084–1.208) | <0.0001 | — | — | 0.753 | <0.0001 |
| SOFA score | 1.435 (1.274–1.616) | <0.0001 | — | — | 0.837 | <0.0001 |
| Mortality | ||||||
| Absent NET formation | Reference | — | Reference | — | — | — |
| Mild NET formation | 1.385 (0.617–3.109) | 0.430 | 1.370 (0.601–3.125) | 0.454 | — | — |
| Moderate NET formation | 3.235 (1.284–8.152) | 0.013 | 2.889 (1.114–7.494) | 0.029 | — | — |
| Strong NET formation | 3.785 (1.506–9.511) | 0.005 | 2.995 (1.162–7.720) | 0.023 | — | — |
| NETs (%) | 1.020 (1.010–1.030) | <0.0001 | 1.016 (1.006–1.026) | 0.002 | 0.851 | <0.0001 |
| cfDNA | 1.000 (1.000–1.000) | 0.232 | 1.000 (1.000–1.000) | 0.532 | 0.607 | 0.324 |
| MPO | 0.998 (0.0994–1.002) | 0.353 | 0.998 (0.993–1.002) | 0.261 | 0.609 | 0.236 |
| DNA–MPO complex | 2.005 (0.430–9.359) | 0.376 | 1.432 (0.286–7.161) | 0.662 | 0.713 | 0.013 |
| IL-1β | 1.008 (0.0981–1.035) | 0.570 | 1.003 (1.011–1.119) | 0.804 | 0.501 | 0.984 |
| IL-6 | 1.000 (1.000–1.000) | 0.907 | 1.000 (1.000–1.000) | 0.904 | 0.596 | 0.064 |
| TNF-α | 0.999 (0.997–1.002) | 0.671 | 0.999 (0.996–1.002) | 0.598 | 0.511 | 0.846 |
| IL-8 | 1.000 (1.000–1.000) | 0.380 | 1.000 (1.000–1.000) | 0.563 | 0.574 | 0.141 |
| APACHE II score | 1.087 (1.047–1.128) | <0.0001 | — | — | 0.683 | <0.0001 |
| SOFA score | 1.087 (1.017–1.162) | 0.014 | — | — | 0.604 | 0.009 |
Definition of abbreviations: APACHE II = Acute Physiology and Chronic Health Evaluation II; AUC = area under the curve; cfDNA = cell-free DNA; DIC = disseminated intravascular coagulation; MPO = myeloperoxidase; NET = neutrophil extracellular trap; SOFA = Sequential Organ Failure Assessment; TNF-α = tumor necrosis factor-α.
Bold indicates P < 0.05.
P value for crude odds ratio to predict DIC and mortality.
P value for adjusted odds ratio to predict DIC and mortality in a multivariable analysis (with patients adjusted for APACHE II scores).
P value for receiver operating characteristic analysis to predict DIC and mortality.