Background and Aims: About 50% of patients admitted to the Intensive Care Unit have systemic inflammatory response syndrome (SIRS), and about 10%C20% of them died. = 0.02) and Simplified Acute Physiology Score II (47 15 vs. 40 15, = 0.01) scores as compared to survivors. NGAL concentrations over 3 days were higher BMS-265246 in nonsurvivors compared to survivors (repeated actions analysis of variance, = 0.02). Day time 1 NGAL, NGAL-24, and NGALc-24 were not individually predictive of mortality. However, day time 3 NGAL, NGAL-48, and NGALc-48 were predictive after modified for age and severity of illness (odds percentage 9.1 [1.97C41.7]). Conclusions: NGAL dynamics over 48 h individually expected mortality in critically ill individuals with SIRS. This could aid clinicians in risk stratification of this group of high-risk individuals. least significant difference analysis. Categorical variables were compared with Chi-square test. The diagnostic and predictive overall performance of NGAL were assessed by area under the curve (AUC) of receiver operating characteristic (ROC) curve of the level of sensitivity versus 1-specificity.[21] The optimal cutoff point was defined as the measured quantity, which maximized sensitivity and specificity.[22] BMS-265246 The differences of the AUC were analyzed using BMS-265246 DeLong method.[23] Survival analysis was performed using KaplanCMeier and Cox regression survival analyses for calculation of hazard ratios (HRs). All AUC, HR, and integrated discrimination improvement were presented with 95% confidence intervals. Results A total of 151 individuals were included in the study. Of these, 53 (35.1%) died in the hospital. Mortality raises with increasing quantity of SIRS criteria (Chi-square test, = 0.05; Table 1). Comparing between each stage, the variations in mortality were significant only between 2 and 4 SIRS criteria (= 0.04). Table 2 compares the baseline demographic, medical characteristics, and end result between individuals survivors and nonsurvivors. Nonsurvivors were older and experienced higher Sequential Organ Failure Assessment (SOFA) and Simplified Acute Physiology Score II (SAPS II) scores as compared to survivors. Table 1 Mortality with quantity of systemic inflammatory response syndrome criteria Table 2 Demographics and medical characteristics between survivors and nonsurvivors Temporal profile of neutrophil BMS-265246 gelatinase-associated lipocalin for 3 days The temporal profile of NGAL between survivors and nonsurvivors is definitely shown in Number 1. NGAL concentrations were consistently higher in nonsurvivors compared to survivors from day time 1 to day time 3 (MannCWhitney test, < 0.04). NGAL and NGALc at 48 h (NGAL-48 and NGALc-48) were higher in nonsurvivors compared to survivors. In contrast, there were no variations in NGAL kinetics at 24 h [Table 3]. Number 1 Temporal profiles of plasma neutrophil gelatinase-associated lipocalin concentration between survivors and nonsurvivors within the 1st 3 days of Intensive Care Unit admission. MannCWhitney test, = 0.04 (day time 1), = 0.02 (day time 2), and = 0.007 ... Table 3 Neutrophil gelatinase-associated lipocalin concentrations and neutrophil gelatinase connected lipocalin between survivors and nonsurvivors Prediction of mortality The AUC of the ROC curve for prediction of mortality is definitely shown in Number 2 and Table 4. Day time 1C3 NGAL were moderately predictive of SDF-5 mortality with AUC of >0.60. NGAL kinetics at 48 h (NGAL-48 and NGALc-48) but not 24 h was predictive of mortality. The variations of the AUC between static and dynamic NGAL are offered in Table 5. Of these, the variations between day time 1 and day time 3 NGAL were significant (?0.05 [?0.1C?0.001], = 0.04). For dynamic NGAL, the variations were significant for NGAL kinetics at 24 versus 48 h, with = 0.03 for both. When comparing static versus dynamic NGAL, variations were only demonstrated for day time 3 NGAL versus NGAL-24 (= 0.04). Number 2 The area under the curve of the level of sensitivity over 1-specificity curve for static and dynamic neutrophil gelatinase-associated lipocalin concentration. Table 4 Area under receiver operating characteristics curve for prediction of mortality Table 5 The variations in the area under curve between static and kinetic of neutrophil gelatinase-associated lipocalin Multivariate logistic regression analysis for prediction of mortality The energy of.