Wei Chang1, Shang Zhu1, Chun Pan1, Jian-Feng Xie1, Song-Qiao Liu1, Hai-Bo Qiu1, Yi Yang2. 1. Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, 87 Dingjiaqiao Rd, Nanjing 210009, PR China. 2. Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, 87 Dingjiaqiao Rd, Nanjing 210009, PR China. Electronic address: yiyiyang2004@163.com.
Abstract
BACKGROUND: We aim to investigate the predictive value of plasma neutrophil gelatinase-associated lipocalin (pNGAL) in patients with severe sepsis. METHODS: A total of 124 patients were enrolled in this observational study. Blood samples were obtained at admission, on day 2 and day 7. Receiver operating characteristic (ROC) curves were generated to assess the utility of pNGAL in prediction of 28-day mortality and need for CRRT. Cox regression curves were built with and without pNGAL for 28-day mortality prediction to determine NGAL's contributive predictive value. RESULTS: Plasma NGAL was significantly increased in non-survivors group on day 2 and 7 and predicted 28-day mortality with AuROC values of 0.675 (95% CI 0.570-0.780) and 0.752 (95% CI 0.619-0.885). Addition of day 2 NGAL to the clinical model resulted in a net reclassification index (NRI) increment of 0.40 (95% CI 0.06-0.75, P = 0.028) for prediction of 28-day mortality. The AuROC of NGAL at admission and day 2 was greater than creatinine in prediction of the need for CRRT. CONCLUSION: Plasma NGAL discriminated 28-day survivors from non-survivors on day 2 and 7 and was a relatively robust predictor of 28-day mortality prediction. Plasma NGAL possibly outperformed creatinine in the prediction of need for CRRT.
BACKGROUND: We aim to investigate the predictive value of plasma neutrophil gelatinase-associated lipocalin (pNGAL) in patients with severe sepsis. METHODS: A total of 124 patients were enrolled in this observational study. Blood samples were obtained at admission, on day 2 and day 7. Receiver operating characteristic (ROC) curves were generated to assess the utility of pNGAL in prediction of 28-day mortality and need for CRRT. Cox regression curves were built with and without pNGAL for 28-day mortality prediction to determine NGAL's contributive predictive value. RESULTS: Plasma NGAL was significantly increased in non-survivors group on day 2 and 7 and predicted 28-day mortality with AuROC values of 0.675 (95% CI 0.570-0.780) and 0.752 (95% CI 0.619-0.885). Addition of day 2 NGAL to the clinical model resulted in a net reclassification index (NRI) increment of 0.40 (95% CI 0.06-0.75, P = 0.028) for prediction of 28-day mortality. The AuROC of NGAL at admission and day 2 was greater than creatinine in prediction of the need for CRRT. CONCLUSION: Plasma NGAL discriminated 28-day survivors from non-survivors on day 2 and 7 and was a relatively robust predictor of 28-day mortality prediction. Plasma NGAL possibly outperformed creatinine in the prediction of need for CRRT.
Authors: Susanne Stads; K Merijn Kant; Margriet F C de Jong; Wouter de Ruijter; Christa M Cobbaert; Michiel G H Betjes; Diederik Gommers; Heleen M Oudemans-van Straaten Journal: Blood Purif Date: 2019-07-22 Impact factor: 2.614
Authors: M Martin-Fernandez; L M Vaquero-Roncero; R Almansa; E Gómez-Sánchez; S Martín; E Tamayo; M C Esteban-Velasco; P Ruiz-Granado; M Aragón; D Calvo; J Rico-Feijoo; A Ortega; E Gómez-Pesquera; M Lorenzo-López; J López; C Doncel; C González-Sanchez; D Álvarez; E Zarca; A Ríos-Llorente; A Diaz-Alvarez; E Sanchez-Barrado; D Andaluz-Ojeda; J M Calvo-Vecino; L Muñoz-Bellvís; J I Gomez-Herreras; C Abad-Molina; J F Bermejo-Martin; C Aldecoa; M Heredia-Rodríguez Journal: BJS Open Date: 2020-02-19