Could Mitochondrial DNA Predict Mortality in Critically Ill Patients?

This systematic review evaluated the literature on mitochondrial DNA (mtDNA) to determine its clinical value as a biomarker of mortality in patients who are critically ill. Researchers queried the PubMed, CINAHL, the Cochrane Library, EMBASE, Scopus, and Web of Science databases, and conducted a search of reference lists of retrieved articles. Eligible studies were those that reported on the association between circulating cell-free mtDNA and all-cause mortality in critically ill patients. Mortality was the primary outcome, and the secondary outcome was morbidity. An initial 1,566 publications was narrowed down to 40 studies encompassing data on 3,450 critically ill patients. The studies differed significantly in how they isolated and measured mtDNA. Of the 40 studies, 16 (40%) explored the link between mtDNA levels and mortality, of which 11 (68.8%) said the relationship was significant. Ten studies measured the area under the receiver operating characteristic (AUROC) curve for mtDNA and mortality, with results ranging from 0.61 to 0.95. The authors concluded that among the studies that included AUROC analysis, a significant correlation between mtDNA levels and mortality is identified. However, the existing trials are small in size, do not have validation cohorts, and lack uniform measuring criteria. The researchers therefore suggested that mtDNA’s clinical value be evaluated through a large, prospective, multi-center trial. Read more