Value of plasma neutrophil gelatinase-associated lipocalin in predicting the mortality of patients with sepsis at the emergency department

Hong, Dae Young; Kim, Jong Won; Paik, Jin Hui; Jung, Hyun Min; Baek, Kwang Je; Park, Sang O; Lee, Kyeong Ryong

doi:10.1016/j.cca.2015.11.026

Cited by 20 publications

(22 citation statements)

References 26 publications

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“…Zhao et al (2015) found median complement 3, membrane attack complex (MAC) and mannose-binding lectin levels increased directly with the sepsis, severe sepsis and septic shock groups, and were significantly higher in non-survivors than in survivors and MEDS score and MAC independently predicted in-hospital mortality, but the prognostic performance of MAC was superior to MEDS. Hong et al (2015) found the area under curve (AUC) of the ROC curve analysis of plasma neutrophil gelatinase-associated lipocalin was greater than that of procalcitonin and MEDS score in predicting 28-day hospital mortality.…”

Section: Discussionmentioning

confidence: 99%

Endocrine and Metabolic Alterations May Underlie Mortality of Severe Sepsis and Septic Shock Patients Admitted to ICU

Ameen¹,

Rehim²,

Shaaban³

2016

JESP

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The study evaluated endocrinal and metabolic response to sepsis and its applicability for the prediction of outcome of septic patients. Patients were 39 adult with severe infections and within 24 h after onset of suspected clinical tissue hypoperfusion. At enrollment patients were evaluated for acute physiology and chronic health evaluation II score (APACHE II) and Glasgow Coma Scale (GCS). Global hemodynamic parameters including systolic blood pressure (SBP), heart rate (HR) and central venous pressure (CVP) were recorded and monitored. All patients were managed at ICU due to Surviving Sepsis Campaign guidelines. ELISA estimated serum copeptin, macrophage migration inhibitory factor (MIF) and total cortisol (TC) and blood la ctate levels. Study outcome was survival rate via 28 days (28-D SR) and best predictor for it. The results showed that 22 patients passed total hospital stay uneventfully for a total survival rate of 56.4%. Seventeen patients died; 10 during ICU stay and 7 during word stay. At admission serum markers levels were significantly higher in survivors and nonsurvivors compared to controls and in non-survivors compared to survivors. Survival showed negative significant correlation with age, high blood lactate and serum copeptin, TC and MIF levels. Survival showed positive significant correlation with SBP, CVP and urine output. ROC curve and Regression analyses defined high at admission serum copeptin and blood lactate levels as significant predictors for mortality of septic patients.

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Section: Discussionmentioning

confidence: 99%

Endocrine and Metabolic Alterations May Underlie Mortality of Severe Sepsis and Septic Shock Patients Admitted to ICU

Ameen¹,

Rehim²,

Shaaban³

2016

JESP

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“…We included 24 articles involving 21 246 patients in our meta-analysis14 21–43 (figure 1). Table 1 lists the sensitivity and specificity of included studies, online supplementary table 2 provides a description of the included articles and online supplementary table 3 is a list of excluded articles with reasons for exclusion.…”

Section: Resultsmentioning

confidence: 99%

“…The stated cut-off value for prediction of mortality using the MEDS score ranged from 7 to 14.5 across the included studies; however, seven studies14 22 25 33 37–39 did not state whether the cut-off value was prespecified or not. Only eight studies21 23 26 27 32 36 41 43 used a prespecified cut-off value and nine studies24 28–31 34 35 40 42 chose an optimal cut-off value based on the Youden index. For the outcome measured, five studies24 28 37 39 43 used in-hospital mortality, and 19 studies14 21–23 25–27 29–36 38 40–42 used 28/30-day mortality.…”

Section: Resultsmentioning

confidence: 99%

Performance of the MEDS score in predicting mortality among emergency department patients with a suspected infection: a meta-analysis

Zhang

Xie

et al. 2019

Emerg Med J

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ObjectivesTo carry out a meta-analysis to examine the prognostic performance of the Mortality in Emergency Department Sepsis (MEDS) score in predicting mortality among emergency department patients with a suspected infection.MethodsElectronic databases—PubMed, Embase, Scopus, EBSCO and the Cochrane Library—were searched for eligible articles from their respective inception through February 2019. Sensitivity, specificity, likelihood ratios and receiver operator characteristic area under the curve were calculated. Subgroup analyses were performed to explore the prognostic performance of MEDS in selected populations.ResultsWe identified 24 studies involving 21 246 participants. The pooled sensitivity of MEDS to predict mortality was 79% (95% CI 72% to 84%); specificity was 74% (95% CI 68% to 80%); positive likelihood ratio 3.07 (95% CI 2.47 to 3.82); negative likelihood ratio 0.29 (95% CI 0.22 to 0.37) and area under the curve 0.83 (95% CI 0.80 to 0.86). Significant heterogeneity was seen among included studies. Meta-regression analyses showed that the time at which the MEDS score was measured and the cut-off value used were important sources of heterogeneity.ConclusionThe MEDS score has moderate accuracy in predicting mortality among emergency department patients with a suspected infection. A study comparison MEDS and qSOFA in the same population is needed.

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“…The overall AUC across the 7 studies was 0.71, suggesting that NGAL was, at best, a fair predictor of mortality. More recently, Hong et al 41 calculated an AUC of 0.80 in 470 patients with sepsis followed for up to 28 days. Meanwhile, Lipinski et al 42 discovered that admission and day one urine levels of NGAL were highly predictive of mortality from pancreatitis, with AUC values of 0.98 and 0.92.…”

Section: Discussionmentioning

confidence: 99%

Urinary neutrophil gelatinase-associated lipocalin is an excellent predictor of mortality in intensive care unit patients

Algethamy

Albeladi

2017

SMJ

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Objectives:To assess urine neutrophil gelatinase-associated lipocalin (uNGAL) level as a potential predictor of acute kidney injury (AKI), and both intensive care unit (ICU) and in-hospital mortality.Methods:Patients presenting to our ICU with a systolic blood pressure (SBP) <90 mmHg or mean arterial pressure (MAP) <65 mmHg, and no prior kidney disease were followed prospectively. Baseline data were collected on patient demographics, admission diagnosis, APACHE II and SOFA scores, SBP, MAP, serum creatinine and cystatin C, and uNGAL. Patients were monitored throughout hospitalization, including daily uNGAL, serum creatinine and cystatin C, and continuous MAP. Bivariate analysis compared those dying in the ICU and in-hospital versus survivors; with hierarchical binary logistic regression used to identify predictors of mortality. Areas under receiver-operating-characteristic curves (AUC) were used to measure sensitivity and specificity at different uNGAL thresholds.Results:Among 75 patients followed, 16 died in the ICU, and another 24 prior to hospital discharge. Mortality rates were greatest in trauma and sepsis patients. The ICU survivors differed from non-survivors in almost all clinical variables; but only 2 predicted ICU mortality on multivariate analysis: day one uNGAL (p=0.01) and 24-hour APACHE II score (p=0.07). Only the APACHE II score significantly predicted in-hospital mortality (p=0.003). The AUC for day one uNGAL was greater for ICU (AUC=0.85) than in-hospital mortality (AUC=0.74).Conclusions:Day one uNGAL is a highly accurate predictor of ICU, but less so for in-hospital mortality.

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Value of plasma neutrophil gelatinase-associated lipocalin in predicting the mortality of patients with sepsis at the emergency department

Cited by 20 publications

References 26 publications

Endocrine and Metabolic Alterations May Underlie Mortality of Severe Sepsis and Septic Shock Patients Admitted to ICU

Endocrine and Metabolic Alterations May Underlie Mortality of Severe Sepsis and Septic Shock Patients Admitted to ICU

Performance of the MEDS score in predicting mortality among emergency department patients with a suspected infection: a meta-analysis

Urinary neutrophil gelatinase-associated lipocalin is an excellent predictor of mortality in intensive care unit patients

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