Prognostic nutritional index predicts acute kidney injury and mortality of patients in the coronary care unit

Background. Anion gap (AG) has been proved to be associated with prognosis of many cardiovascular diseases. This study is aimed at exploring the association of AG with inhospital all-cause mortality and adverse clinical outcomes in coronary care unit (CCU) patients. Method. All data of this study was extracted from Medical Information Mart for Intensive Care III (MIMIC-III, version 1.4) database. All patients were divided into four groups according to AG quartiles. Primary outcome was inhospital all-cause mortality. Lowess smoothing curve was drawn to describe the overall trend of inhospital mortality. Binary logistic regression analysis was performed to determine the independent effect of AG on inhospital mortality. Result. A total of 3593 patients were enrolled in this study. In unadjusted model, as AG quartiles increased, inhospital mortality increased significantly, OR increased stepwise from quartile 2 (OR, 95% CI: 1.01, 0.74-1.38, P=0.958) to quartile 4 (OR, 95% CI: 2.72, 2.08-3.55, P<0.001). After adjusting for possible confounding variables, this association was attenuated, but still remained statistically significant (quartile 1 vs. quartile 4: OR, 95% CI: 1.02, 0.72-1.45 vs. 1.49, 1.07-2.09, P=0.019). Moreover, CCU mortality (P<0.001) and rate of acute kidney injury (P<0.001) were proved to be higher in the highest AG quartiles. Length of CCU (P<0.001) and hospital stay (P<0.001) prolonged significantly in higher AG quartiles. Maximum sequential organ failure assessment score (SOFA) (P<0.001) and simplified acute physiology score II (SAPSII) (P<0.001) increased significantly as AG quartiles increased. Moderate predictive ability of AG on inhospital (AUC: 0.6291), CCU mortality (AUC: 0.6355), and acute kidney injury (AUC: 0.6096) was confirmed. The interactions were proved to be significant in hypercholesterolemia, congestive heart failure, chronic lung disease, respiratory failure, oral anticoagulants, Beta-blocks, angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB), and vasopressin treatment subgroups. Conclusion. AG was an independent risk factor of inhospital all-cause mortality and was associated with adverse clinical outcomes in CCU patients.

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Incidence and mortality of acute kidney injury in patients with acute coronary syndrome: A retrospective study from a single coronary care unit

Saudi Journal of Kidney Diseases and Transplantation ◽

10.4103/1319-2442.185238 ◽

2016 ◽

Vol 27 (4) ◽

pp. 752 ◽

Cited By ~ 5

Author(s):

Mahdia Buargub ◽

ZohraOmar Elmokhtar

Keyword(s):

Acute Kidney Injury ◽

Acute Coronary Syndrome ◽

Retrospective Study ◽

Coronary Care Unit ◽

Kidney Injury ◽

Coronary Syndrome ◽

Incidence And Mortality ◽

Coronary Care

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Acute Kidney Injury Biomarkers for Patients in a Coronary Care Unit: A Prospective Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0032328 ◽

2012 ◽

Vol 7 (2) ◽

pp. e32328 ◽

Cited By ~ 26

Author(s):

Tien-Hsing Chen ◽

Chih-Hsiang Chang ◽

Chan-Yu Lin ◽

Chang-Chyi Jenq ◽

Ming-Yang Chang ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Coronary Care Unit ◽

Kidney Injury ◽

Coronary Care

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Presepsin and prognostic nutritional index are predictors of septic acute kidney injury, renal replacement therapy initiation in sepsis patients, and prognosis in septic acute kidney injury patients: a pilot study

BMC Nephrology ◽

10.1186/s12882-021-02422-x ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Yuichiro Shimoyama ◽

Osamu Umegaki ◽

Noriko Kadono ◽

Toshiaki Minami

Keyword(s):

Acute Kidney Injury ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Kidney Injury ◽

Prognostic Nutritional Index ◽

Lymphocyte Ratio ◽

Nutritional Index ◽

Therapy Initiation ◽

Septic Acute Kidney Injury ◽

Renal Replacement Therapy Initiation

Abstract Background Sepsis is the most common cause of acute kidney injury (AKI) among critically ill patients. This study aimed to determine whether presepsin is a predictor of septic acute kidney injury, renal replacement therapy initiation (RRTi) in sepsis patients, and prognosis in septic AKI patients. Methods Presepsin values were measured immediately after ICU admission (baseline) and on Days 2, 3, and 5 after ICU admission. Glasgow Prognostic Score (GPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio, Prognostic Index, and Prognostic Nutritional Index (PNI) were measured at baseline, and total scores (“inflammation-presepsin scores [iPS]”) were calculated for category classification. Presepsin values, inflammation-based prognostic scores, and iPS were compared between patients with and without septic AKI or RRTi and between survivors and non-survivors. Results Receiver operating characteristic curve analyses identified the following variables as predictors of septic AKI and RRTi in sepsis patients: presepsin on Day 1 (AUC: 0.73) and Day 2 (AUC: 0.71) for septic AKI, and presepsin on Day 1 (AUC: 0.71), Day 2 (AUC: 0.9), and Day 5 (AUC: 0.96), Δpresepsin (Day 2 – Day 1) (AUC: 0.84), Δpresepsin (Day 5 – Day 1) (AUC: 0.93), and PNI (AUC: 0.72) for RRTi. Multivariate logistic regression analyses identified presepsin on Day 2 as a predictor of prognosis in septic AKI patients. Conclusions Presepsin and PNI were found to be predictors of septic AKI, RRTi in sepsis patients, and prognosis in septic AKI patients.

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Neutrophil Percentage to Albumin Ratio Was Associated with Clinical Outcomes in Coronary Care Unit Patients

10.21203/rs.3.rs-729333/v1 ◽

2021 ◽

Author(s):

Chenghui Cai ◽

Tienan Sun ◽

Fang Zhao ◽

Jun Ma ◽

Xin Pei ◽

...

Keyword(s):

Acute Kidney Injury ◽

Hospital Mortality ◽

Coronary Care Unit ◽

Kidney Injury ◽

Roc Curves ◽

Albumin Ratio ◽

Cumulative Survival ◽

Kaplan Meier ◽

Neutrophil Percentage ◽

Coronary Care

Abstract Background: Neutrophil percentage to albumin ratio (NPAR) was proved to be correlated with the prognosis of a variety of diseases. The purpose of this study was to explore the effect of NPAR on the prognosis of coronary care unit (CCU) dpatients.Method: All data of this study was extracted from Medical Information Mart for Intensive Care III (MIMIC-III, version1.4) database. All patients were divided into four groups according to NPAR quartiles. Primary outcome was in-hospital mortality and secondary outcomes were 30-day mortality, 365-day mortality, length of CCU stay, length of hospital stay, acute kidney injury, renal replacement therapy. Multivariable binary logistic regression analysis was performed to confirm the independent effect of NPAR. Subgroup analysis was used to determine the effect of NPAR on in-hospital mortality in different subgroups. Receiver-operating characteristic (ROC) curves were applied to evaluate the ability of NPAR to predict in-hospital mortality. Kaplan–Meier curves were built to compare cumulative survival of different groups.Result: 2364 CCU patients were enrolled in this study. In-hospital mortality rate increased significantly as NPAR quartiles increased (P < 0.001). In multivariable logistic regression, NPAR was proved to be independently associated with in-hospital mortality (Quartile 4 vs Quartile 1: OR, 95% CI: 1.80, 1.19-2.72, P=0.005, P for trend = 0.001). Moderate ability of NPAR to predict in-hospital mortality was demonstrated through ROC curves, the AUC of NPAR was 0.653 (P<0.001), which is better than PLR (P<0.001), neutrophil (P<0.001) but lower than SOFA(P=0.046) and SAPS II (P<0.001). Subgroup analysis did not find obvious interaction in most subgroups. Moreover, Kaplan-Meier curves showed that as NPAR quartiles increased, 30-day (Log rank, P<0.001) and 365-day (Log rank, P<0.001) cumulative survival decreased significantly. NPAR was also proved to be independently associated with acute kidney injury (Quartile 4 vs Quartile 1: OR, 95% CI: 1.57, 1.19-2.07, P=0.002, P for trend = 0.001). Length of CCU and hospital stay were prolonged significantly in higher NPAR quartiles.Conclusion: NPAR was an independent risk factor of in-hospital mortality in CCU patients and had a moderate ability to predict in-hospital mortality.

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Presepsin and Prognostic Nutritional Index are predictors of septic acute kidney injury, renal replacement therapy initiation in sepsis patients, and prognosis in septic acute kidney injury patients: a pilot study

10.21203/rs.3.rs-366947/v1 ◽

2021 ◽

Author(s):

Yuichiro Shimoyama ◽

Osamu Umegaki ◽

Noriko Kadono ◽

Toshiaki Minami

Keyword(s):

Acute Kidney Injury ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Kidney Injury ◽

Prognostic Nutritional Index ◽

Lymphocyte Ratio ◽

Nutritional Index ◽

Therapy Initiation ◽

Septic Acute Kidney Injury ◽

Renal Replacement Therapy Initiation

Abstract Background Sepsis is the most common cause of acute kidney injury (AKI) among critically ill patients. This study aimed to determine whether presepsin is a predictor of septic acute kidney injury, renal replacement therapy initiation (RRTi) in sepsis patients, and prognosis in septic AKI patients. Methods Presepsin values were measured immediately after ICU admission (baseline) and on Days 2, 3, and 5 after ICU admission. Glasgow Prognostic Score (GPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio, Prognostic Index, and Prognostic Nutritional Index (PNI) were measured at baseline. Total scores were calculated (hereafter, “inflammation-presepsin scores [iPS]”) for category classification. Presepsin values, inflammation-based prognostic scores, and iPS were compared between patients with and without septic AKI or RRTi and between survivors and non-survivors. Results Receiver operating characteristic curve analyses identified the following variables as predictors of septic AKI and RRTi in sepsis patients: presepsin on Day 1 (AUC: 0.73) and Day 2 (AUC: 0.71) for septic AKI, and presepsin on Day 1 (AUC: 0.71), Day 2 (AUC: 0.9), and Day 5 (AUC: 0.96), Δpresepsin (Day 2 – Day 1) (AUC: 0.84), Δpresepsin (Day 5 – Day 1) (AUC: 0.93), and PNI (AUC: 0.72) for RRTi. Multivariate logistic regression analyses identified presepsin on Day 2 as a predictor of prognosis in septic AKI patients. Conclusions Presepsin and PNI were found to be predictors of septic AKI, RRTi in sepsis patients, and prognosis in septic AKI patients.

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