title: Value of plasma neutrophil gelatinase-associated lipocalin in predicting the mortality of patients with sepsis at the emergency department.
abstract: BACKGROUND
  Sepsis is a major cause of morbidity and mortality in the emergency department. This study aimed to evaluate the assessment of severity of sepsis by and prognostic value of plasma neutrophil gelatinase-associated lipocalin (NGAL) compared with other widely used biological markers of inflammation in patients with sepsis.
  
  
  METHODS
  NGAL, procalcitonin, and C-reactive protein values were measured in 470 patients with suspected sepsis, and the Mortality in Emergency Department Sepsis (MEDS) score was obtained for all enrolled subjects, who were followed for up to 28days.
  
  
  RESULTS
  The median plasma NGAL value was increased with sepsis severity according to the MEDS score. The plasma NGAL value was higher in nonsurvivors than in survivors. The area under the receiver operating characteristic curve of NGAL (0.797) was greater than that of procalcitonin (0.599) and MEDS score (0.774) in predicting 28-day hospital mortality. Multivariable logistic regression found that the plasma NGAL value was an independent predictor for hospital mortality in patients with sepsis. The plasma NGAL values were positively correlated with C-reactive protein and procalcitonin levels, and MEDS scores.
  
  
  CONCLUSIONS
  Plasma NGAL is a valuable biological marker in the assessment of severity and prediction of prognosis of patients with sepsis in the emergency department.
authors.affiliation: Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors.forename: Dae Young
authors.initials: DY
authors.lastname: Hong
authors.affiliation: Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, College of Medicine, Inha University, Incheon, Republic of Korea.
authors.forename: Jin Hui
authors.initials: JH
authors.lastname: Paik
authors.affiliation: Department of Emergency Medicine, College of Medicine, Inha University, Incheon, Republic of Korea.
authors.forename: Hyun Min
authors.initials: HM
authors.lastname: Jung
authors.affiliation: Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors.forename: Kwang Je
authors.initials: KJ
authors.lastname: Baek
authors.affiliation: Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors.forename: Sang O
authors.initials: SO
authors.lastname: Park
authors.affiliation: Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea. Electronic address: kuhemlkr@gmail.com.
authors.forename: Kyeong Ryong
authors.initials: KR
authors.lastname: Lee
mesh_terms: D000209:Acute-Phase Proteins; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood; D011518:Proto-Oncogene Proteins / Q000097:blood*; D018805:Sepsis / Q000097:blood* / Q000401:mortality*; D012720:Severity of Illness Index; D015996:Survival Rate
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C000606589:CALCA protein, human; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011498:Protein Precursors; D011518:Proto-Oncogene Proteins; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide
keywords: Emergency department; Neutrophil gelatinase-associated lipocalin; Procalcitonin; Sepsis