VALUE OF SERUM IRON AND URINE NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN IN PREDICTING THE MORTALITY OF CRITICALLY ILL PATIENTS WITH SEPSIS

Abstract

Introduction:Weaimed to investigate the association of ironmetabolism-related parameters with 60-day mortality incritically ill patients with sepsis. Methods: Serum or urine concentrations of ironmetabolism-related parameters on intensive care unit ad-mission were measured in aprospective cohort of 133 eligible patients with sepsis according to the Sepsis-3 criteria, and the sevalues were compared between survivors and nonsurvivors, categorized according to their 60-days urvival status. Cox regression analyses were performed to examine the association between iron parameters and 60-day mortality. Kaplan-Meier methods were used to illustrate the differences in survival between different iron parameters. Results: Of the 133 patients included in the study, 61(45.8%) had died by day 60. After adjusting for confound-ingvariables, higher concentration s of serum iron (cut-off9.5μmol/mL)and higher concentrations of urine neutrophil gelatinase-associated lipocalin (uNGAL; cut-off 169.3ng/mL)were associated with asignificantly greater risk of death in the Coxreg ressionanalysis. These two biomarkers combined with Sequential Organ Failure Assessment (SOFA) scores increased the are a under the receiver operating characteristic (AUROC) curveto 0.85. Discussion: These finding ssuggest that higher concentrations of serumiron and uNGA Lare each associated with higher60-day mortality, and they add significant accuracy to this prediction in combination with SOFA. Abbreviations: uNGAL: urine neutrophil gelatinase-associated lipocalin; ICU: intensive care unit; SOFA:Se-quential Organ Failure Assessment; APACHEII: the Acute Physiology and Chronic Health Evaluation II; ELISA: enzyme-linked immunos or bentassay; HR: hazard ratio; CIs: confidence intervals; WBC: white blood cell; TBIL: total bilirubin