Methods of risk assessment and disease classification

Abstract

A method of measuring risk assessment in a patient with appendicitis is disclosed. The method comprises: (a) measuring the TRAIL protein level in a blood sample of the patient; and (b) providing a risk assessment based on the TRAIL protein level.

What is claimed is: 
     
         1 . A method of treating a subject comprising:
 (a) measuring the TRAIL protein level in a blood sample of the subject;   (b) measuring the level of at least two components of a clinical index of the subject; (c) providing a risk assessment based on the combination of said TRAIL protein level and said level of said at least two components of said clinical index; and   (d) treating the subject according to the risk assessment.   
     
     
         2 . The method of  claim 1 , wherein said measuring the level of said at least two components of said clinical index comprises measuring all the components of said clinical index. 
     
     
         3 . The method of  claim 2 , wherein said clinical index is selected from the group consisting of APACHE I, APACHE II, APACHE III, CURB-65, SMART-COP, SAPS II, SAPS III, PIM2, CMM, SOFA, MPM, RIFLE, CP, MODS, LODS, Rochester criteria, Philadelphia Criteria, Milwaukee criteria and Ranson score. 
     
     
         4 . The method of  claim 1 , wherein the subject is a hospitalized subject. 
     
     
         5 . The method of  claim 1 , wherein the subject is in the Emergency department. 
     
     
         6 . The method  claim 1 , wherein the subject is in the Intensive care unit (ICU). 
     
     
         7 . The method of  claim 1 , wherein when the TRAIL protein level is below 25 pg/ml, the risk assessment is raised. 
     
     
         8 . The method of  claim 1 , wherein when said level of said at least two components of said clinical index is indicative of a low risk patient and said TRAIL protein level is below 25 pg/ml, the patient is classified as an intermediate risk patient. 
     
     
         9 . The method of  claim 1 , wherein said level of said at least two components of said clinical index is indicative of an intermediate risk patient and said TRAIL protein level is below 25 pg/ml, the patient is classified as a high risk patient. 
     
     
         10 . The method of  claim 9 , wherein said treating comprises a management course selected from the group consisting of mechanical ventilation, invasive monitoring, sedation, intensive care admission, surgical intervention, drug of last resort and hospital admittance. 
     
     
         11 . The method of  claim 1 , wherein when said level of said at least two components of said clinical index is indicative of a high risk patient and said TRAIL protein level is above 25 pg/ml, the patient is classified as an intermediate risk patient. 
     
     
         12 . The method of  claim 1 , wherein said blood sample is a fraction of whole blood. 
     
     
         13 . The method of  claim 1 , wherein said blood sample comprises cells selected from the group consisting of lymphocytes, monocytes and granulocytes. 
     
     
         14 . The method of  claim 1 , wherein said fraction is serum or plasma. 
     
     
         15 . The method of  claim 1 , wherein said measuring is determined electrophoretically or immunochemically. 
     
     
         16 . The method of  claim 15 , wherein said immunochemical determination is effected by flow cytometry, radioimmunoassay, immunofluorescence, lateral flow immunoassay or by an enzyme-linked immunosorbent assay.