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J Korean Soc Emerg Med > Volume 27(5); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(5): 482-487.
응급의료센터에 내원한 심부전 환자의 예후 예측인자로서 Nuertrophil Gelatinase-Associated Lipocalin의 유용성
강대화1, 김상일1, 박준범1, 정혜진1, 이영주1, 박수연2, 조영신1
1순천향대학교 의과대학 응급의학교실
2순천향대학교 의과대학 통계학교실
Usefulness of Neurtiophil Gelatinase-Associated Lipocalin as a Prognosis Predictor in Heart Failure Patients in Emergency Department
Dae Hwa Kang1, Sang-Il Kim1, Joon Bum Park1, Hye Jin Chung1, Young Ju Lee1, Suyeon Park2, Young Shin Cho1
1Department of Emergency Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
2Department of Biostatistics, Soonchunhyang University College of Medicine, Seoul, Korea
Correspondence  Young Shin Cho ,Tel: 02-709-9119, Fax: 02-709-9083, Email: emcys0819@gmail.com,
Received: June 7, 2016; Revised: June 9, 2016   Accepted: July 12, 2016.  Published online: October 30, 2016.
ABSTRACT
Purpose:
We aimed to investigate the clinical use of plasma neutrophil gelatinase-associated lipocalin (NGAL) in the emergency department (ED), especially for predicting the prognosis of heart failure.
Method:
In a retrospective study, patient selection was based on those who visited the ED between January 2015 and September 2015 and were diagnosed with heart failure and underwent laboratory tests, including B-type natriuretic peptide (BNP) and NGAL. They were divided in two groups, according to the presence or absence of the following events: one or more intubations, admission of intensive care unit (ICU), coronary angiography, renal replacement therapy, extracorporeal membrane oxygenation, intra-aortic balloon pumping, cardiopulmonary resuscitation (CPR), or death.
Results:
We studied 63 patients with heart failure. The absence group consisted of 29 subjects, and the presence group consisted of 34 subjects. Patients who were younger, had a history of diabetes mellitus, had high level of serum creatinine, low estimated glomerular filtration (eGFR), high creatine kinase (CK) or high NGAL were associated with higher incidence of events and were statistically significant (p<0.001, 0.02, 0.005, 0.035, 0.03, 0.003). In the case of BNP, the presence group showed a higher value compared with the absence group, but was not statistically significant. In a multivariated logistic regression, age (OR=0.868, 95% confidence interval 0.788-0.956, p=0.004) and NGAL (OR=1.004, 95%CI 1.001-1.007, p=0.021) were considered as meaningful factors for predicting the event.
Conclusion:
NGAL elevation in this study showed to be a meaningful factor, indicating a prognosis to those patients who visited the ED and were diagnosed as heart failure.
Key words: Heart failure, Neurtiophil Gelatinase-Associated Lipocalin (NGAL), Prognosis
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