Initial triaging in the Emergency Department (ED) is one of the most critical steps to securing good patient outcomes. Triage involves a complex decision-making process carried out by specially trained nurses, technicians, and doctors based on vital signs, complaints, respiratory rate, oxygen saturation in blood, pulse, level of consciousness, blood pressure, age, and body temperature. All around the world, clinicians have different methods to assess the risk stratification of patients in hospitals to categorize the urgency and need of care. Internationally there is, however, no consensus on the protocol used for the decision-making process. Now, an easy-to-use, quantitative test for early warning and patient triaging measures levels of the prognostic biomarker suPAR to allow clinicians and nurses to obtain a fast patient prognosis for patient disease severity, progression and outcome. In addition, the results of the test designed for use in the Point of Care situation can quickly be achieved on-site at the ED, avoiding passing via the core laboratory.

The suPARnostic Quick Triage test from ViroGates A/S (Birkeroed, Denmark) used together with the aLF reader from QIAGEN N.V. (Venlo, Netherlands) delivers quick and fully quantitative urokinase plasminogen activator (suPAR) results for better triage of patients in ED settings. suPAR is the soluble form of the cell membrane-bound protein uPAR, a three-domain receptor mainly expressed on immune cells, including neutrophils, activated T-cells, macrophages, endothelial cells, and smooth muscle cells. uPAR is released during inflammation or immune activation, and therefore the suPAR level reflects the extent of immune activation in the individual.

The normal suPAR plasma level is below 4 ng/mL in healthy individuals, about 4-6 ng/mL in unselected patients in Emergency Departments, and above 6 ng/mL in critically ill patients. A low suPAR level indicates a good prognosis and supports the decision to discharge the patient. A high suPAR level indicates the presence, progression, and severity of disease, and supports further clinical attention. High plasma suPAR levels have been associated with increased severity and mortality in COVID-19, HIV, sepsis, tuberculosis , malaria, auto-immune diseases, Streptococcus pneumonia bacteremia, cancer, Alzheimer’s, cardiovascular diseases, organ failure, neoplastic and pregnancy relation conditions, and type 2 diabetes mellitus. suPAR may be of particularly high value in triage in the ED due to the high degree of unspecificity.

The suPARnostic Quick Triage test is based on the lateral flow principle. The test device consists of a nitrocellulose membrane with two immobilized antibody zones and a running buffer. The aLF Reader reads the quantitative results with a detection interval of 2-15 ng/mL suPAR. The easy-to-use test offers a short and straightforward procedure with fully quantitative results, enabling the clinician to act immediately if suPAR levels are abnormal. Early test results will facilitate better triage and improve the decision-making process, giving the clinician a faster patient prognosis and prioritizing patients with unclear signs and history.

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