Urine neutrophil gelatinase-associated lipocalin predicts outcome and renal failure in open and endovascular thoracic abdominal aortic aneurysm surgery.

ABSTRACT: Urine neutrophil gelatinase-associated lipocalin (uNGAL) has been evaluated as a biomarker for AKI detection and adverse outcome in open and endovascular thoracoabdominal aortic aneurysm surgery. This observational, retrospective study included 52 patients. UNGAL was measured peri-operatively (48?h) and correlated with AKI requiring dialysis, tracheotomy and adverse outcome. Mean patients' age was 64.5 years. A total of 26.9% (n?=?14) developed AKI, and 21.1% (n?=?11) required dialysis, tracheotomy rate was 19.2% (n?=?10) and in-hospital mortality rate was 7.6% (n?=?4). uNGAL levels were related to AKI requiring dialysis at ICU (p?=?0.0002), need for tracheotomy at baseline and admission on ICU (p?=?0.0222, p?=?0.0028, respectively), as well as adverse discharge modality (p?=?0.0051, p?=?0.0048, respectively). Diagnostic quality was good for uNGAL levels at admission to ICU regarding AKI requiring dialysis (sensitivity: 81.8% [48.2-97.7]; specificity: 87.8% [73.8-95.9]; area under the curve (AUC): 0.874 [0.752-0.949]). The diagnostic quality of uNGAL was favorable for the prediction of tracheotomy (sensitivity: 70.0% [34.8-93.3]; specificity: 83.3% [68.6-93.0]; AUC: 0.807 [0.674-0.903]) and adverse discharge (sensitivity: 77.8% [40.0-97.2]; specificity: 83.7% [69.3-93.2]; AUC: 0.817 [0.685-0.910]). uNGAL may be valuable as an post-operative predictor of AKI and adverse outcome after open and endovascular TAAA repair.

SUBMITTER: Gombert A 

PROVIDER: S-EPMC6107559 | biostudies-other | 2018 Aug

REPOSITORIES: biostudies-other