Background
Methods
Patients
Data
Measurement of uNGAL
Statistical analyses
Results
Data available (of 484) | N (%) or median [IQR] | |
---|---|---|
Age (years) | 484 | 65 [54–75] |
Gender (male) | 484 | 310 (64) |
Baseline serum/plasma creatinine (µmol/l) | 338 | 78 [62–95] |
Co-morbidity | ||
Chronic obstructive pulmonary disease | 476 | 51 (11) |
Hypertension | 484 | 255 (53) |
Atherosclerosis | 484 | 64 (13) |
Diabetes | 484 | 117 (24) |
Systolic heart failure | 484 | 64 (13) |
Chronic kidney disease | 484 | 35 (7) |
Admission type | ||
Emergency | 482 | 465 (96) |
Surgical | 484 | 123 (25) |
Diagnostic group (APACHE II) | 484 | |
Respiratory tract, non-operative | 109 (23) | |
Cardiovascular, non-operative | 65 (13) | |
Sepsis | 64 (13) | |
Gastrointestinal tract, operative | 63 (13) | |
Gastrointestinal tract, non-operative | 36 (7) | |
Neurological, non-operative | 26 (5) | |
Metabolic | 23 (5) | |
Cardiovascular, operative | 23 (5) | |
Other (< 4% each) | 75 (15) | |
Other | ||
Need for vasopressor (in first 3 ICU days) | 484 | 359 (74) |
Highest lactate (day of admission, mmol/l) | 484 | 1.9 [1.4–2.9] |
Highest creatinine (day of admission, µmol/l) | 476 | 88 [63–140] |
Cumulative diuresis (first 24 h, ml) | 482 | 2042 [1300–2953] |
SOFA (highest score, points) | 484 | 8 [6–11] |
SAPS II score (points) | 484 | 40 [32–53] |
Mechanical ventilation | 484 | 342 (71) |
Emergency surgery (< 1 week) | 482 | 118 (24) |
Length of stay ICU (days) | 484 | 4.0 [2.2–7.6] |
Length of stay hospital (days) | 483 | 12 [7–21] |
AUC
AKI | Severe AKI (KDIGO 2–3) | RRT | 90-day mortality | |
---|---|---|---|---|
Goodness of fita (clinical risk model) | 0.406 | 0.400 | 0.973 | 0.365 |
Goodness of fita (new model including uNGAL) | 0.395 | 0.338 | 0.749 | 0.990 |
Events (n) | 217 | 134 | 46 | 136 |
Nonevents (n) | 267 | 350 | 438 | 348 |
AUC | ||||
uNGAL alone | 0.690 (0.647 to 0.731) | 0.728 (0.686 to 0.767) | 0.769 (0.729 to 0.806) | 0.600 (0.555 to 0.644) |
Clinical risk model | 0.717 (0.670 to 0.764) | 0.759 (0.710 to 0.809) | 0.724 (0.643 to 0.805) | 0.797 (0.754 to 0.840) |
New risk model (uNGAL added) | 0.749 (0.704 to 0.794) | 0.799 (0.755 to 0.843) | 0.824 (0.761 to 0.886) | 0.804 (0.762 to 0.846) |
Difference, p (clinical model vs new model) | 0.017 | 0.011 | 0.005 | 0.27 |
Category-free NRI (%) | ||||
cfNRIevents | 1.38 (− 12 to 14.77) | 22.39 (6.11 to 38.67) | 47.83 (21.91 to 73.74) | − 4.41 (− 21.06 to 12.23) |
cfNRInonevents | 48.69 (38.25 to 59.13) | 49.14 (39.99 to 58.29) | 46.58 (38.54 to 54.62) | 34.48 (24.67 to 44.3) |
cfNRI | 50.07 (33.01 to 67.13) | 71.53 (52.88 to 90.19) | 94.4 (67.16 to 121.65) | 30.07 (10.71 to 49.43) |
IDI and summary statistics | ||||
IDIevents | 0.0248 (0.0099 to 0.0398) | 0.0398 (0.0185 to 0.061) | 0.0615 (0.0361 to 0.0868) | 0.0115 (− 0.0003 to 0.0233) |
IDInonevents | 0.0202 (0.0092 to 0.0312) | 0.0152 (0.0049 to 0.0256) | 0.0065 (− 0.0007 to 0.0136) | 0.0045 (− 0.0008 to 0.0099) |
IDI | 0.045 (0.0264 to 0.0637) | 0.055 (0.0317 to 0.0782) | 0.0679 (0.0413 to 0.0945) | 0.016 (0.0032 to 0.0289) |
ISold | 0.5263 (0.5006 to 0.5519) | 0.408 (0.3711 to 0.4449) | 0.1947 (0.1344 to 0.255) | 0.4509 (0.4112 to 0.4905) |
ISnew | 0.5511 (0.5226 to 0.5796) | 0.4476 (0.4083 to 0.487) | 0.2557 (0.1917 to 0.3197) | 0.4623 (0.4214 to 0.5032) |
IPold | 0.3849 (0.3651 to 0.4048) | 0.2267 (0.2111 to 0.2422) | 0.0846 (0.0781 to 0.0911) | 0.2146 (0.1968 to 0.2325) |
IPnew | 0.3648 (0.3425 to 0.3871) | 0.2115 (0.1937 to 0.2293) | 0.0782 (0.0693 to 0.0871) | 0.2102 (0.192 to 0.2283) |