Neutrophil Gelatinase-Associated Lipocalin (NGAL) as a Predictor for Sepsis Mortality in Children Admitted to Pediatric Intensive Care Unit (PICU): A Comparison With Prothrombin Time/International Normalized Ratio (PT/INR) and Urea/Creatinine Ratio.

Autor:	Abdelrazic MI; Pediatrics, Faculty of Medicine, Minia University, Minya, EGY., Abdel Hakeem GL; Pediatrics, Faculty of Medicine, Minia University, Minya, EGY., Hanna MS; Pediatrics, Faculty of Medicine, Minia University, Minya, EGY., Mohamed OM; Clinical Pathology, Faculty of Medicine, Minia University, Minya, EGY., Ismail DE; Clinical Pathology, Faculty of Medicine, Minia University, Minya, EGY., Abuelela IS; Pediatrics, Faculty of Medicine, Minia University, Minya, EGY.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Oct 29; Vol. 16 (10), pp. e72643. Date of Electronic Publication: 2024 Oct 29 (Print Publication: 2024).
DOI:	10.7759/cureus.72643
Abstrakt:	Background Sepsis is the primary cause of death in children, and it is crucial to identify patients at high risk of mortality early on in order to provide intensive monitoring and management in the Pediatric Intensive Care Unit (PICU). Objective The objective of this study was to assess the predictive value of routinely used sepsis indicators, including neutrophil gelatinase-associated lipocalin (NGAL), urea to creatinine ratio (urea/Cr), and prothrombin time and international normalized ratio (PT/INR), in predicting death in critically unwell children. Patients and methods A total of 75 children were included in the research conducted at the PICU of Minia University. Among them, 21 (28%) were released as survivors, while the remaining 54 (72%) unfortunately passed away. All participating children were subjected to serum NGAL, urea/Cr, and PT/INR measurements during the first 24 hours of hospitalization. The severity of sepsis was assessed using the Pediatric Risk of Mortality (PRISM) III score. Results The NGAL, prothrombin, urea, and creatinine levels were considerably elevated in the group of individuals who died compared to those who survived (P < 0.001, 0.007, 0.028, and 0.032, respectively). However, no significant difference was found between survivors and deceased children in terms of the PT/INR ratio and urea/Cr ratio. When predicting mortality, NGAL with a cutoff point of more than 990 had a sensitivity of 100% and a specificity of 35%. Similarly, the PRISM score with a cutoff point greater than 18 had a sensitivity of 83.3% and a specificity of 42.9%. Conclusion Serum NGAL is reliable in the early prediction of mortality in children admitted with sepsis. Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. The Institutional Review Board (IRB), Faculty of Medicine, Minia University issued approval 388:2022. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Abdelrazic et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu