{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:41:13Z","timestamp":1775176873492,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Early stratification of patients at emergency department (ED) admission is crucial. The soluble urokinase plasminogen activator receptor (suPAR) has emerged as a promising biomarker to identify the worsening of different clinical conditions. We aimed at evaluating whether baseline suPAR values predict 28-day and 90-day mortality in patients presenting to the ED with different conditions. Methods: In this prospective observational study, we enrolled patients with dyspnoea (D), chest pain (CP), and abdominal pain (AP). suPAR levels, together with clinical and laboratory data, were recorded at ED admission. The data collected included 28-day and 90-day mortality data, as well as 28-day and 90-day hospital readmission; and their correlation with suPAR values was assessed. Results: We enrolled 298 consecutive patients (CP 23.8%, D 31.9%, AP 44.3%). suPAR was significantly higher in patients with dyspnoea, compared to both patients with chest and abdominal pain (5.50 [3.50\u20138.60], 3.20 [2.30\u20134.10], 3.20 [2.33\u20134.48] ng\/mL, respectively; p &lt; 0.001). suPAR plasmatic levels were also higher in patients admitted to semi-intensive or intensive care units compared to other patients (4.10 [3.15\u20138.05] vs. 3.50 [2.55\u20135.50] ng\/mL, respectively; p = 0.049). suPAR levels were significantly higher in patients dead at 28 days than in survivors (12.65 [9.83\u201318.53] vs. 3.60 [2.60\u20135.48] ng\/mL, respectively; p &lt; 0.001). Using the stepwise logistic regression analysis, only suPAR emerged as an independent predictor of 28-day mortality with an odds ratio of 1.31 (95% CI 1.10\u20131.56). Conclusions: Baseline suPAR levels are an independent predictor of mortality in ED patients with chest pain, dyspnoea, or abdominal pain.<\/jats:p>","DOI":"10.3390\/diagnostics15222851","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T10:56:27Z","timestamp":1762858587000},"page":"2851","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Soluble Urokinase Plasminogen Activator Receptor (suPAR) Predicts 28-Day and 90-Day Mortality in Emergency Department Patients with Chest Pain, Dyspnoea, or Abdominal Pain"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0581-245X","authenticated-orcid":false,"given":"Francesco","family":"Gavelli","sequence":"first","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, 28100 Novara, Italy"},{"name":"Emergency Medicine Unit, \u201cAzienda Ospedaliero-Universitaria Maggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca Maria","family":"Giolitti","sequence":"additional","affiliation":[{"name":"Emergency Medicine Unit, \u201cAzienda Ospedaliero-Universitaria Maggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Vidali","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, 28100 Novara, Italy"},{"name":"Clinical Pathology Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Montersino","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6936-4249","authenticated-orcid":false,"given":"Matteo","family":"Bertoli","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7372-4953","authenticated-orcid":false,"given":"Luca","family":"Molinari","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, 28100 Novara, Italy"},{"name":"Emergency Medicine Unit, \u201cAzienda Ospedaliero-Universitaria Maggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5595-6224","authenticated-orcid":false,"given":"Marco","family":"Baldrighi","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, 28100 Novara, Italy"},{"name":"Emergency Medicine Unit, \u201cAzienda Ospedaliero-Universitaria Maggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Beltrame","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, 28100 Novara, Italy"},{"name":"Emergency Medicine Unit, \u201cAzienda Ospedaliero-Universitaria Maggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8322-9158","authenticated-orcid":false,"given":"Pier Paolo","family":"Sainaghi","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, 28100 Novara, Italy"},{"name":"Department of Internal Medicine, \u201cAzienda Ospedaliero-Universitaria Maggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1488-8736","authenticated-orcid":false,"given":"Mattia","family":"Bellan","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, 28100 Novara, Italy"},{"name":"Emergency Medicine Unit, \u201cAzienda Ospedaliero-Universitaria Maggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Patrucco","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, 28100 Novara, Italy"},{"name":"Respiratory Diseases Unit, \u201cAzienda Ospedaliero-Universitaria Maggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7611-8345","authenticated-orcid":false,"given":"Gian Carlo","family":"Avanzi","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, 28100 Novara, Italy"},{"name":"Emergency Medicine Unit, \u201cAzienda Ospedaliero-Universitaria Maggiore della Carit\u00e0\u201d, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8248-1976","authenticated-orcid":false,"given":"Luigi Mario","family":"Castello","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Universit\u00e0 degli Studi del Piemonte Orientale, 28100 Novara, Italy"},{"name":"Internal Medicine Unit, \u201cAzienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo\u201d, 15100 Alessandria, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"ref_1","unstructured":"CDC\u2014Centre for Disease Control, and National Center for Health Statistics (U.S.) (2025, August 24). National Hospital Ambulatory Medical Care Survey: 2021 Emergency Department Summary Tables, Available online: https:\/\/www.cdc.gov\/nchs\/fastats\/emergency-department.htm."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.ejim.2024.05.015","article-title":"Sepsis Scoring Systems: Mindful Use in Clinical Practice","volume":"125","author":"Castello","year":"2024","journal-title":"Eur. J. Intern. Med."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Guan, G., Lee, C.M.Y., Begg, S., Crombie, A., and Mnatzaganian, G. (2022). The Use of Early Warning System Scores in Prehospital and Emergency Department Settings to Predict Clinical Deterioration: A Systematic Review and Meta-Analysis. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0265559"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1016\/j.ajem.2018.10.058","article-title":"Comparison of SIRS, qSOFA, and NEWS for the Early Identification of Sepsis in the Emergency Department","volume":"37","author":"Usman","year":"2019","journal-title":"Am. J. Emerg. Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Bruhn, R., Skj\u00f8t-Arkil, H., Skovsted, T.A., Brasen, C.L., Andersen, E.S., Heltborg, A., Hertz, M.A., Petersen, E.R.B., Mogensen, C.B., and Torres, A. (2025). Biomarker Profiling for Infection Diagnosis in Emergency Departments: A Diagnostic Study Evaluating C-Reactive Protein, Procalcitonin, Club Cell Protein 16, Interleukin-6, Chitinase-like Protein, and Soluble Urokinase-Type Plasminogen Activator Receptor. Clin. Biochem., 138.","DOI":"10.1016\/j.clinbiochem.2025.110943"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Rasmussen, L.J.H., Petersen, J.E.V., and Eugen-Olsen, J. (2021). Soluble Urokinase Plasminogen Activator Receptor (suPAR) as a Biomarker of Systemic Chronic Inflammation. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.780641"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e35718","DOI":"10.1097\/MD.0000000000035718","article-title":"Role of Soluble Urokinase Type Plasminogen Activator Receptor (suPAR) in Predicting Mortality, Readmission, Length of Stay and Discharge in Emergency Patients: A Systematic Review and Meta Analysis","volume":"102","author":"Rehan","year":"2023","journal-title":"Medicine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2498628","DOI":"10.1080\/0886022X.2025.2498628","article-title":"The Predictive Value of suPAR for Glomerular Segmental Sclerosis Lesions in Renal Pathology","volume":"47","author":"Zhang","year":"2025","journal-title":"Ren. Fail."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e70121","DOI":"10.1111\/liv.70121","article-title":"Soluble Urokinase Plasminogen Activator Receptor Predicts Survival and Hepatic Decompensation in Advanced Hepatocellular Carcinoma","volume":"45","author":"Artusa","year":"2025","journal-title":"Liver Int."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Wang, Y., Wu, F., Chen, C., Xu, L., Lin, W., Huang, C., Yang, Y., Wu, S., Qi, J., and Cao, H. (2021). Soluble Urokinase Plasminogen Activator Receptor Is Associated with Short-Term Mortality and Enhanced Reactive Oxygen Species Production in Acute-on-Chronic Liver Failure. BMC Gastroenterol., 21.","DOI":"10.1186\/s12876-021-02006-x"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e70077","DOI":"10.1002\/joa3.70077","article-title":"Soluble Urokinase Plasminogen Activator Receptor (suPAR) as a Prognostic Biomarker in Acutely Admitted Patients with Atrial Fibrillation","volume":"41","author":"Wisborg","year":"2025","journal-title":"J. Arrhythm."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e25040","DOI":"10.1002\/jcla.25040","article-title":"The Role of Soluble Urokinase Plasminogen Activator Receptor (suPAR) as an Early Indicator of Mortality in Pediatric Septic Shock","volume":"38","author":"Turan","year":"2024","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"120303","DOI":"10.1016\/j.cca.2025.120303","article-title":"suPAR as a Biomarker of Support in Different Clinical Settings","volume":"573","author":"Belvederi","year":"2025","journal-title":"Clin. Chim. Acta"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s13054-018-1943-y","article-title":"Serum suPAR and Syndecan-4 Levels Predict Severity of Community-Acquired Pneumonia: A Prospective, Multi-Centre Study","volume":"22","author":"Luo","year":"2018","journal-title":"Crit. Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1097\/SHK.0000000000001434","article-title":"The Diagnostic and Prognostic Value of suPAR in Patients with Sepsis: A Systematic Review and Meta-Analysis","volume":"53","author":"Huang","year":"2020","journal-title":"Shock"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.ejim.2019.04.007","article-title":"Plasma Level of Soluble Urokinase Plasminogen Activator Receptor (suPAR) Predicts Long-Term Mortality after First Acute Alcohol-Induced Pancreatitis","volume":"64","author":"Aronen","year":"2019","journal-title":"Eur. J. Intern. Med."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ohnewein, B., Shomanova, Z., Jirak, P., Paar, V., Topf, A., Pylypenko, L., Sch\u00e4binger, M., Volg, F., Hoppe, U.C., and Pistulli, R. (2025). Dynamics of the Novel Cardiac Biomarkers sST2, H-FABP, GDF-15 and suPAR in HFrEF Patients Undergoing Heart Failure Therapy, a Pilot Study. J. Clin. Med., 14.","DOI":"10.3390\/jcm14165668"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1111\/joim.20108","article-title":"Soluble Urokinase Plasminogen Activator Receptor and Interleukin-6 Improves Prediction of All-Cause Mortality and Major Adverse Cardiovascular Events in Type 1 Diabetes","volume":"298","author":"Bahrami","year":"2025","journal-title":"J. Intern. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e70089","DOI":"10.1111\/crj.70089","article-title":"The Value of Soluble Urokinase Plasminogen Activator Receptor (suPAR) as Predictive Tool in Hospitalised Patients With Community-Acquired Pneumonia (CAP)","volume":"19","author":"Hessels","year":"2025","journal-title":"Clin. Respir. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"91","DOI":"10.4137\/BMI.S19876","article-title":"Risk Factors Associated with Serum Levels of the Inflammatory Biomarker Soluble Urokinase Plasminogen Activator Receptor in a General Population","volume":"9","author":"Haupt","year":"2014","journal-title":"Biomark. Insights"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"R130","DOI":"10.1186\/cc11434","article-title":"Plasma suPAR Levels Are Associated with Mortality, Admission Time, and Charlson Comorbidity Index in the Acutely Admitted Medical Patient: A Prospective Observational Study","volume":"16","author":"Haupt","year":"2012","journal-title":"Crit. Care"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1136\/emermed-2015-205444","article-title":"Soluble Urokinase Plasminogen Activator Receptor (suPAR) in Acute Care: A Strong Marker of Disease Presence and Severity, Readmission and Mortality. A Retrospective Cohort Study","volume":"33","author":"Rasmussen","year":"2016","journal-title":"Emerg. Med. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1097\/CCM.0000000000003441","article-title":"Combining National Early Warning Score With Soluble Urokinase Plasminogen Activator Receptor (suPAR) Improves Risk Prediction in Acute Medical Patients: A Registry-Based Cohort Study","volume":"46","author":"Rasmussen","year":"2018","journal-title":"Crit. Care Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s13049-019-0621-7","article-title":"Availability of suPAR in Emergency Departments May Improve Risk Stratification: A Secondary Analysis of the TRIAGE III Trial","volume":"27","author":"Schultz","year":"2019","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3403549","DOI":"10.1155\/2019\/3403549","article-title":"Early Discharge from the Emergency Department Based on Soluble Urokinase Plasminogen Activator Receptor (suPAR) Levels: A TRIAGE III Substudy","volume":"2019","author":"Schultz","year":"2019","journal-title":"Dis. Markers"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.1016\/j.amjcard.2012.08.008","article-title":"Usefulness of Soluble Urokinase Plasminogen Activator Receptor to Predict Repeat Myocardial Infarction and Mortality in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Intervention","volume":"110","author":"Marott","year":"2012","journal-title":"Am. J. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e015457","DOI":"10.1161\/JAHA.119.015457","article-title":"Sex Differences in Circulating Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) Levels and Adverse Outcomes in Coronary Artery Disease","volume":"9","author":"Mehta","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/j.bbi.2025.06.030","article-title":"Executive Function and Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR): A Longitudinal Study of Midlife Adults","volume":"129","author":"Shell","year":"2025","journal-title":"Brain Behav. Immun."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/22\/2851\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T11:12:51Z","timestamp":1762859571000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/22\/2851"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,11]]},"references-count":28,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["diagnostics15222851"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15222851","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,11]]}}}