scholarly journals Hypoalbuminemia as a Predictor of Adverse Outcome in Critically Ill Children: A Prospective Cohort Study

2021 ◽  
Author(s):  
Abeer Yehia El-shamy ◽  
Ahmed Anwar Khattab ◽  
Alyaa Ahdy Adbel-Aziz
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Critically Ill ◽  
Prospective Cohort ◽  
Poor Prognosis ◽  
Pediatric Patients ◽  
Albumin Level ◽  
Critically Ill Children ◽  
P Value ◽  
Risk Of Mortality

Abstract Background hypoalbuminemia is a common finding in critically ill patients associated with a high risk of mortality, but there is lack of data on its role in pediatric patients. The aim of this study is to investigate the effect of low albumin levels in pediatric patients on poor prognosis and high risk of mortality in the pediatric intensive care unit (PICU). Methods This was a prospective cohort study conducted at the PICU at El-Bagour hospital from November 2018 to November 2020. The aim was to evaluate low albumin level as a predictor of poor prognosis and clinical outcome in 150 critically ill children aged one month up to 18 years. ROC curve was used to assess the discriminatory ability of scoring systems for patients’ mortality. Results 148 patients were included in the final analysis where the incidence of hypoalbuminemia in the 1st 48-h postadmission was 44.6% with an overall mean serum albumin level of 3.34 ± 0.78. Hypoalbuminemia was an independent factor of mortality prediction. Moreover, we found children with hypoalbuminemia had higher mortality rate (p-value < 0.001), higher PICU stays (p-value = 0.016), lower galscow coma score (GSC) (p-value = 0.0017), and more need of mechanical ventilation (p-value < 0.001). Conclusion hypoalbuminemia may be used as a significant predictor of mortality and risk assessment in critically ill children.

scholarly journals Serum cystatin is a useful marker for the diagnosis of acute kidney injury in critically ill children: prospective cohort study

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Osama Y. Safdar ◽  
Mohammed Shalaby ◽  
Norah Khathlan ◽  
Bassem Elattal ◽  
Mohammed Bin Joubah ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Critically Ill ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Serum Cystatin

scholarly journals Cystatin C- an early marker indicative of renal dysfunction in critically ill children: a prospective cohort study

2019 ◽  
Vol 6 (5) ◽  
pp. 1981
Author(s):  
Hawwa M.S. Siddiqua ◽  
Mathew John ◽  
V. C. Manoj ◽  
Rati Santhakumar
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Serum Creatinine ◽  
Renal Dysfunction ◽  
Critically Ill ◽  
Cystatin C ◽  
Prospective Cohort ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Serum And Urine

Background: Acute kidney injury (AKI) is a sudden onset of kidney failure or kidney damage that happens within a few hours or a few days and can also affect other organs such as brain, heart and the lungs. Hence early diagnosis and intervention is needed to improve the outcome of the children. In these studies this objective was to determine if cystatin C is an early marker indicative of renal dysfunction in critically ill children and to determine if Cystatin C can detect Acute kidney injury earlier than serum creatinine.Methods: This prospective cohort study was undertaken in PICU at Jubilee Mission Medical College from December 2016- May 2018. Blood samples were collected from 34 critically ill children for serum creatinine estimation at 0,24 and 48 hours of admission and serum and urine were collected for cystatin C estimation at admission. Children were categorized into AKI and NON-AKI based on pRIFLE criteria. Comparison of cystatin C values with serum creatinine was performed and Statistical analysis was done using IBM SPSS version 20.Results: A total of 34 critically ill children were enrolled in this study, out of which 12 children progressed to AKI during the course of illness according to modified Pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease (pRIFLE) criteria. We found a strong positive correlation between cystatin C at 0 hours and serum creatinine at 48 hours among AKI groups.Conclusions: Serum and Urine cystatin C are early markers to diagnose AKI in critically ill children. Serum cystatin C is more sensitive than urine cystatin C for the diagnosis of AKI.

scholarly journals Paediatric RIFLE and AKIN Classification for Detection and Outcome of Acute Kidney Injury in Critically Sick Children. Which is Better? A Prospective Cohort Study

2018 ◽  
Vol 38 (1) ◽  
pp. 31-37
Author(s):  
Pareshkumar A Thakkar ◽  
Neha Pandey ◽  
Kalpita S Shringarpure
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Critically Ill ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Schwartz Formula ◽  
Sick Children

Introduction: Acute Kidney Injury (AKI) is becoming increasingly common in both developed and developing countries with significant morbidity and mortality. However, the precise incidence of AKI in children is not well known due to lack of uniformity in various definitions of AKI. This study was carried out to compare incidence of AKI using two different definitions-pRIFLE and AKIN.Material and Methods: This was a prospective cohort study conducted in the paediatric ICU of a tertiary care government hospital attached to a Medical College of Central Gujarat, India. Total 115 critically ill paediatric patients aged one month to 12 years were included in the study. Serum Creatinine (SCr) levels were tested and Glomerular filtration rate (GFR) was calculated using the Schwartz formula at 0, 6, 12, 24 and 48 hours of admission. Patients were assessed for AKI using AKIN and pRIFLE classification.Results: Incidence of AKI was 80% and 66.9% in critically ill children, as classified by pRIFLE and AKIN classification respectively. Paediatric RIFLE labelled 15 more patients as AKI which were classified as non-AKI by AKIN criteria. There was moderate agreement in between the two classifications to diagnose stages of AKI (Kappa 0.474, CI- 0.359 to 0.589). With increasing grades of AKI, mortality was higher using pRIFLE staging; unlike the AKIN staging wherein this was not observed.Conclusion: The pRIFLE criteria detects a greater number of cases of AKI compared to AKIN criteria. Based on severity staging, pRIFLE is more consistent with adverse outcome of patients with AKI compared to AKIN classification. Overall mortality is significant high in patients with AKI compared to patients without AKI using any of the classifications.  

scholarly journals Hypomagnesemia as a predictor of mortality in critically ill pediatric patients in picu using prism score

2019 ◽  
Vol 6 (3) ◽  
pp. 1294
Author(s):  
Poornima Shankar ◽  
N. Varsha Monica Reddy ◽  
Shiva Devaraj
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Pediatric Patients ◽  
Clinical Status ◽  
Critically Ill Children ◽  
P Value ◽  
Prism Score ◽  
Low Magnesium ◽  
Prediction Of Mortality ◽  
High Prevalence

Background: Magnesium is the fourth most abundant cation in the human body and the second most abundant intracellular cation after potassium. A potential relationship between low magnesium levels and increased mortality has been suggested in the literature. The objectives were to detect prevalence of hypomagnesemia in critically ill children, its association with sepsis and to correlate this with mortality.Methods: This study was an observational study done on 100 children who met the inclusion criteria, admitted to the PICU of Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India. Patients under the study were managed and treated according to their clinical status and supportive traditional treatment.Results: Prevalence of hypomagnesemia in critically ill pediatric patients was 53%. In this study, majority of the cases admitted to PICU were dengue (19%) and bronchopneumonia (15%) which were significantly associated with hypomagnesemia as p value was less than 0.05. As regard prognosis, Mg had an AUC of 0.576 for prediction of mortality whereas the AUC for PRISM score was 0.811. Logistic regression analysis showed that hypomagnesemia is a significant predictor for mortality among critically ill children (p value=0.028) and OR=3.180 (0.854-7.965).Conclusions: Present study has found high prevalence of hypomagnesemia in critically ill patients. Hypomagnesemia was associated with a higher mortality rate in critically ill patients and commonly associated with infections and respiratory diseases. Hypomagnesemia indicated poor outcome and higher mortality rates in critically ill patients.

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