J 2018

Prediction of major adverse kidney events in critically ill burn patients

DEPRET, F., L. BOUTIN, Jiří JARKOVSKÝ, M. CHAUSSARD, S. SOUSSI et. al.

Basic information

Original name

Prediction of major adverse kidney events in critically ill burn patients

Authors

DEPRET, F. (250 France), L. BOUTIN (250 France), Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution), M. CHAUSSARD (250 France), S. SOUSSI (250 France), A. BATAILLE (250 France), H. OUESLATI (250 France), N. MORENO (250 France), C. de TYMOWSKI (250 France), Jiří PAŘENICA (203 Czech Republic, belonging to the institution), Klára BENEŠOVÁ (203 Czech Republic, belonging to the institution), T. VAUCHEL (250 France), A. FERRY (250 France), M. BENYAMINA (250 France), A. CUPACIU (250 France), M. COUTROT (250 France), J.P. GARNIER (250 France), K. SERROR (250 France), M. CHAOUAT (250 France), A. MEBAZAA (250 France) and M. LEGRAND (250 France, guarantor)

Edition

Burns, OXFORD, ELSEVIER SCI LTD, 2018, 0305-4179

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 2.247

RIV identification code

RIV/00216224:14110/18:00104900

Organization unit

Faculty of Medicine

UT WoS

000451331200004

Keywords in English

Plasmatic Neutrophil Gelatinase-Associated Lipocain; Acute kidney injury; Burn patients; Major adverse kidney event

Tags

Tags

International impact, Reviewed
Změněno: 23/4/2024 10:05, Mgr. Michal Petr

Abstract

V originále

Objective: We aimed at assessing the predictive value of plasmatic Neutrophil Gelatinase Associated Lipocalin (pNGAL) at admission and severity scores to predict major adverse kidney events (MAKE, defined as death and/or need for renal replacement therapy (RRT) and/or non-renal recovery at day 90) in critically ill burn patients. Material and methods: Single-center cohort study in a burn critical care unit in a tertiary center, including all consecutive severely burn patients (total burned body surface >20%) from January 2012 until January 2015 with a pNGAL dosage at admission. Reclassification of patients was assessed by Integrated Discrimination Improvement (IDI). Measurements and results: 87 patients were included. Mean age was 47.7 (IQ 25-75: 33.4-65.2) years; total burn body surface area was 40 (IQ 25-75: 30-55) % and ICU mortality 36%. 39(44.8%) patients presented a MAKE, 32(88.9%) patients died at day 90. pNGAL was higher in the MAKE group (423 [IQ25-75: 327-518] pg/mL vs 184 [IQ25-75: 147-220] pg/mL, p<0.001). In multivariate analysis, pNGAL and abbreviated burn severity index (ABSI) remained associated with MAKE (OR 1.005 [CI 95% 1.0005-1.009], p=0.03 and OR 1.682 [CI95%1.038-2.726], p=0.035 respectively). Adding pNGAL to abbreviated burn severity index, simplified organ failure assessment and the simplified acute physiology score 2 did outperform clinical scores for the prediction of MAKE and AKI and for most severe forms of AKI and allowed a statistically significant reclassification of patients compared to ABSI for MAKE, RRT, AKI at Day 7 and AKI during hospitalization with a number of patients needed to screen to detect one extra episode of MAKE was 44, 13 for severe AKI and 15 for AKI. Conclusions: pNGAL at admission is associated with the risk of MAKE in this population, and outperform severity scores when associated. Interventional studies are now needed to assess if impact of biomarkers-guided strategies would improve outcome. (C) 2018 Elsevier Ltd and ISBI. All rights reserved.