Butyrylcholinesterase Activity as a Mortality Marker in ICU Patients: An Individual Participant Data Meta-Analysis.
Ricardo Esper Treml, Iago T C Grillo, Anna Hrabovska et al.
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In 30 seconds
This meta-analysis evaluated the prognostic value of butyrylcholinesterase (BChE) activity for in-hospital mortality in critically ill adults, primarily those with sepsis. Analyzing data from six ICU cohorts totaling 482 patients, the study found that lower Day-1 BChE levels were independently associated with increased mortality (OR per 100 U/L, 0.979; p < 0.001), with a threshold of 1615 U/L indicating higher risk.
Key findings
- Lower Day-1 BChE levels were associated with increased mortality (OR per 100 U/L, 0.979; p < 0.001).
- BChE below 1615 U/L predicted higher mortality with a hazard ratio of 1.69 (95% CI, 1.11-2.59; log-rank p = 0.015).
- The pooled area under the curve for BChE as a mortality predictor was 0.72 (95% CI, 0.65-0.83).
- The inverse association between BChE levels and mortality was confirmed in the meta-analysis (pooled OR per 1 sd, 0.22; p = 0.023).
Why it matters
Understanding the prognostic implications of BChE activity can aid clinicians in identifying critically ill patients at higher risk of mortality, particularly in sepsis. This biomarker may enhance existing assessment tools for patient management.