Urinary neutrophil gelatinase-associated lipocalin-guided risk assessment for major adverse kidney events after open-heart surgery.
Biomark Med
; 12(9): 975-985, 2018 09.
Article
em En
| MEDLINE
| ID: mdl-30088425
ABSTRACT
AIM:
To assess weather doctors' clinical risk-assessment for major adverse kidney events (MAKE) and acute kidney injury (AKI) after open-heart surgery would improve when being informed about neutrophil gelatinase-associated lipocalin (NGAL) test result at ICU admission. PATIENTS &METHODS:
Clinical risk-assessment for MAKE and AKI were performed with and without providing NGAL test result and compared in an exploratory- and a validation-cohort using reclassification metrics, exemplary category-free net reclassification improvement (cfNRI).RESULTS:
Exploratory cohort doctors' prediction of MAKE (cfNRI = 0.750 [0.130-1.370]; p = 0.018) and AKI (cfNRI = 0.565 [0.001-1.129]; p = 0.049) improved being provided with NGAL test information. This finding was confirmed in the validation-cohort (MAKE cfNRI = 0.930 [0.188-1.672]; p = 0.014) and the combined-cohort (MAKE cfNRI = 0.847 [0.371-1.323], p < 0.001); AKI cfNRI = 0.468 [0.099-0.836; p = 0.013]). Improvements mostly generated from correctly reclassifying patients who not developed events (p < 0.001).CONCLUSION:
Biomarker informed risk-assessment is superior in predicting MAKE and AKI after open-heart surgery.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Injúria Renal Aguda
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Lipocalina-2
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Procedimentos Cirúrgicos Cardíacos
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Biomark Med
Assunto da revista:
BIOQUIMICA
/
MEDICINA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Alemanha