title: Preoperative urinary neutrophil gelatinase-associated lipocalin and outcome in high-risk heart failure patients undergoing cardiac surgery.
abstract: OBJECTIVE
  To investigate the ability of early urinary neutrophil gelatinase-associated lipocalin to predict postoperative complications in adult patients with ventricular dysfunction undergoing cardiac surgery.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Single-center study, university hospital.
  
  
  METHODS
  Fifty-six adult high-risk cardiac surgical patients with preoperative cardiac failure.
  
  
  METHODS
  None.
  
  
  RESULTS
  Demographic and clinical characteristics were obtained, and neutrophil gelatinase-associated lipocalin was measured at baseline and at several time points after surgery. Patient characteristics and neutrophil gelatinase-associated lipocalin levels were related to renal and patient outcome. On multivariate analyses, preoperative urinary neutrophil gelatinase-associated lipocalin was an independent predictor of length of intensive care stay (p = 0.004) and in-hospital stay (p = 0.04), but not of acute kidney injury or renal replacement therapy and was not associated with baseline renal function.
  
  
  CONCLUSIONS
  In a cohort of high-risk cardiac surgery patients, preoperative urinary neutrophil gelatinase-associated lipocalin value provided prognostic information that was independent of the onset of acute kidney injury or of preoperative renal function.
authors.affiliation: Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milano, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Silvetti
authors.affiliation: Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milano, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Meroni
authors.affiliation: Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milano, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Bignami
authors.affiliation: Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milano, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Bove
authors.affiliation: Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milano, Italy. Electronic address: landoni.giovanni@hsr.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Landoni
authors.affiliation: Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milano, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Zangrillo
authors.affiliation: Departments of Intensive Care and Cardiac Surgery, Austin Health, Melbourne, Australia.
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
authors.affiliation: Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milano, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Pappalardo
mesh_terms: D058186:Acute Kidney Injury / Q000652:urine; D000209:Acute-Phase Proteins / Q000652:urine*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000652:urine; D002303:Cardiac Output, Low / Q000209:etiology; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003422:Critical Care; D005260:Female; D006333:Heart Failure / Q000601:surgery* / Q000652:urine*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D007677:Kidney Function Tests; D007902:Length of Stay; D016014:Linear Models; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine*; D049449:Luminescence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000652:urine*; D017582:Renal Replacement Therapy; D018570:Risk Assessment; D016896:Treatment Outcome; D018754:Ventricular Dysfunction / Q000601:surgery
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D002316:Cardiotonic Agents; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins
keywords: acute kidney injury; cardiac surgery; intensive care; neutrophil gelatinase-associated lipocalin