Selenoprotein P predicting mortallity in acute ill patients with dyspnea.

Abstract

Background and aims: Good Selenium (Se) status predicts favorable prognoses for various diseases and a reduced overall mortality. The primary objective of the study was to determine whether Selenium status, i.e. Selenoprotein P (SeP) levels, is associated with risk of 90-day mortality in elderly patients with acute dyspnea at the Emergency Department (ED).

Methods and results: Patients presenting with dyspnea were enrolled from the ED at the University Hospital in Malmö between 2013 and 2018. Cox regression analyses were conducted to evaluate hazard ratios (HRs) for 90-day mortality. This analysis was performed in two steps. Model A included adjustments for age and sex with 95 % confidence intervals (95 % CI) for individual factors such as SeP levels, the Medical Emergency Triage and Treatment System - Adult (METTS-A), BMI levels, comorbidities, and smoking status. Model B was a multivariate analysis with 99 % confidence intervals (99 % CI), incorporating age, sex, and statistically significant factors from Model A, including SeP levels, BMI, heart failure, anemia, and stroke. A lower concentration of SeP was independently associated with a higher risk of death within 90 days. In the continuous model of SeP, the HR was 0.798 (99 % CI 0.678-0.940). When comparing the lowest quartile to the highest quartile of SeP, the HR was 2.462 (99 % CI 1.240-4.891).

Conclusion: Low SeP concentrations were found to predict 90-day mortality in ED patients presenting with dyspnea. The assessment of SeP levels could serve as a valuable tool in the initial evaluation of elderly patients in the ED.