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Dynamic changes of plasma neutrophil gelatinase-associated lipocalin predicted mortality in critically ill patients with systemic inflammatory response syndrome

Background and Aims: About 50% of patients admitted to the Intensive Care Unit have systemic inflammatory response syndrome (SIRS), and about 10%-20% of them died. Early risk stratification is important to reduce mortality. Plasma neutrophil gelatinase-associated lipocalin (NGAL) is increased by inf...

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Main Authors: Md Ralib, Azrina, Nanyan, Suhaila, Mat Nor, Mohd Basri
Format: Article
Language:English
English
English
Published: Medknow Publications 2017
Subjects:
R Medicine (General)
Online Access:http://irep.iium.edu.my/54892/1/IJCCM21123-8022692_221706.pdf
http://irep.iium.edu.my/54892/13/54892-ynamic%20changes%20of%20plasma%20neutrophil%20gelatinase-associated%20lipocalin%20predicted%20mortality-SCOPUS.pdf
http://irep.iium.edu.my/54892/19/54892_Dynamic%20changes%20of%20plasma%20neutrophil_WOS.pdf
http://irep.iium.edu.my/54892/
http://www.ijccm.org/temp/IJCCM21123-7884125_215401.pdf
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spelling my.iium.irep.548922020-11-09T02:27:07Z http://irep.iium.edu.my/54892/ Dynamic changes of plasma neutrophil gelatinase-associated lipocalin predicted mortality in critically ill patients with systemic inflammatory response syndrome Md Ralib, Azrina Nanyan, Suhaila Mat Nor, Mohd Basri R Medicine (General) Background and Aims: About 50% of patients admitted to the Intensive Care Unit have systemic inflammatory response syndrome (SIRS), and about 10%-20% of them died. Early risk stratification is important to reduce mortality. Plasma neutrophil gelatinase-associated lipocalin (NGAL) is increased by inflammation and infection. Its ability to predict mortality in SIRS patients is of interest. We evaluated the ability of serial measurement of NGAL for the prediction of mortality in critically ill patients with SIRS. Materials and Methods: This is a secondary analysis of a single-center, prospective, observational study. Patients who fulfill the SIRS criteria were recruited in the study. Delta NGAL at 24 and 48 h (ΔNGAL-24 and ΔNGAL-48) was defined as 24 and 48 h NGAL minus day 1 NGAL; NGAL clearance (NGALc) was defined as percentage of ΔNGAL over day 1 NGAL. The primary outcome of the study is in-hospital mortality. Results: A total of 151 patients were analyzed, of which 53 (35%) died. Nonsurvivors were older (51 vs. 45, P = 0.03) and had higher Sequential Organ Failure Assessment (9 ± 7 vs. 7 ± 4, P = 0.02) and Simplified Acute Physiology Score II (47 ± 15 vs. 40 ± 15, P = 0.01) scores as compared to survivors. NGAL concentrations over 3 days were higher in nonsurvivors compared to survivors (repeated measures analysis of variance, P = 0.02). Day 1 NGAL, ΔNGAL-24, and NGALc-24 were not independently predictive of mortality. However, day 3 NGAL, ΔNGAL-48, and NGALc-48 were predictive after adjusted for age and severity of illness (odds ratio 9.1 [1.97-41.7]). Conclusions: NGAL dynamics over 48 h independently predicted mortality in critically ill patients with SIRS. This could assist clinicians in risk stratification of this group of high-risk patients. Medknow Publications 2017-01 Article PeerReviewed application/pdf en http://irep.iium.edu.my/54892/1/IJCCM21123-8022692_221706.pdf application/pdf en http://irep.iium.edu.my/54892/13/54892-ynamic%20changes%20of%20plasma%20neutrophil%20gelatinase-associated%20lipocalin%20predicted%20mortality-SCOPUS.pdf application/pdf en http://irep.iium.edu.my/54892/19/54892_Dynamic%20changes%20of%20plasma%20neutrophil_WOS.pdf Md Ralib, Azrina and Nanyan, Suhaila and Mat Nor, Mohd Basri (2017) Dynamic changes of plasma neutrophil gelatinase-associated lipocalin predicted mortality in critically ill patients with systemic inflammatory response syndrome. Indian Journal of Critical Care Medicine, 21 (1). pp. 23-29. ISSN 0972-5229 E-ISSN 1998-359X http://www.ijccm.org/temp/IJCCM21123-7884125_215401.pdf 10.4103/0972-5229.198322
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
English
English
topic R Medicine (General)
spellingShingle R Medicine (General)
Md Ralib, Azrina
Nanyan, Suhaila
Mat Nor, Mohd Basri
Dynamic changes of plasma neutrophil gelatinase-associated lipocalin predicted mortality in critically ill patients with systemic inflammatory response syndrome
description Background and Aims: About 50% of patients admitted to the Intensive Care Unit have systemic inflammatory response syndrome (SIRS), and about 10%-20% of them died. Early risk stratification is important to reduce mortality. Plasma neutrophil gelatinase-associated lipocalin (NGAL) is increased by inflammation and infection. Its ability to predict mortality in SIRS patients is of interest. We evaluated the ability of serial measurement of NGAL for the prediction of mortality in critically ill patients with SIRS. Materials and Methods: This is a secondary analysis of a single-center, prospective, observational study. Patients who fulfill the SIRS criteria were recruited in the study. Delta NGAL at 24 and 48 h (ΔNGAL-24 and ΔNGAL-48) was defined as 24 and 48 h NGAL minus day 1 NGAL; NGAL clearance (NGALc) was defined as percentage of ΔNGAL over day 1 NGAL. The primary outcome of the study is in-hospital mortality. Results: A total of 151 patients were analyzed, of which 53 (35%) died. Nonsurvivors were older (51 vs. 45, P = 0.03) and had higher Sequential Organ Failure Assessment (9 ± 7 vs. 7 ± 4, P = 0.02) and Simplified Acute Physiology Score II (47 ± 15 vs. 40 ± 15, P = 0.01) scores as compared to survivors. NGAL concentrations over 3 days were higher in nonsurvivors compared to survivors (repeated measures analysis of variance, P = 0.02). Day 1 NGAL, ΔNGAL-24, and NGALc-24 were not independently predictive of mortality. However, day 3 NGAL, ΔNGAL-48, and NGALc-48 were predictive after adjusted for age and severity of illness (odds ratio 9.1 [1.97-41.7]). Conclusions: NGAL dynamics over 48 h independently predicted mortality in critically ill patients with SIRS. This could assist clinicians in risk stratification of this group of high-risk patients.
format Article
author Md Ralib, Azrina
Nanyan, Suhaila
Mat Nor, Mohd Basri
author_facet Md Ralib, Azrina
Nanyan, Suhaila
Mat Nor, Mohd Basri
author_sort Md Ralib, Azrina
title Dynamic changes of plasma neutrophil gelatinase-associated lipocalin predicted mortality in critically ill patients with systemic inflammatory response syndrome
title_short Dynamic changes of plasma neutrophil gelatinase-associated lipocalin predicted mortality in critically ill patients with systemic inflammatory response syndrome
title_full Dynamic changes of plasma neutrophil gelatinase-associated lipocalin predicted mortality in critically ill patients with systemic inflammatory response syndrome
title_fullStr Dynamic changes of plasma neutrophil gelatinase-associated lipocalin predicted mortality in critically ill patients with systemic inflammatory response syndrome
title_full_unstemmed Dynamic changes of plasma neutrophil gelatinase-associated lipocalin predicted mortality in critically ill patients with systemic inflammatory response syndrome
title_sort dynamic changes of plasma neutrophil gelatinase-associated lipocalin predicted mortality in critically ill patients with systemic inflammatory response syndrome
publisher Medknow Publications
publishDate 2017
url http://irep.iium.edu.my/54892/1/IJCCM21123-8022692_221706.pdf
http://irep.iium.edu.my/54892/13/54892-ynamic%20changes%20of%20plasma%20neutrophil%20gelatinase-associated%20lipocalin%20predicted%20mortality-SCOPUS.pdf
http://irep.iium.edu.my/54892/19/54892_Dynamic%20changes%20of%20plasma%20neutrophil_WOS.pdf
http://irep.iium.edu.my/54892/
http://www.ijccm.org/temp/IJCCM21123-7884125_215401.pdf
_version_ 1683230333749690368
score 13.244414

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