Predictive value of plasma neutrophil gelatinase-associated lipocalin in acute charcoal-burning carbon monoxide poisoning

This study aimed to assess the feasibility of using the plasma neutrophil gelatinase-associated lipocalin (NGAL) level at the time of presentation in the emergency department (ED) to predict acute kidney injury (AKI) and the long-term neurological outcomes of acute charcoal-burning carbon monoxide (...

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Bibliographic Details
Published in:Human & experimental toxicology 2019-08, Vol.38 (8), p.877-887
Main Authors: Moon, JM, Chun, BJ, Shin, MH, Cho, YS
Format: Article
Language:English
Subjects:
Academic Medical Centers
Acute Kidney Injury - blood
Adult
Aged
Burning
Carbon monoxide
Carbon monoxide poisoning
Carbon Monoxide Poisoning - blood
Charcoal
Emergency medical services
Emergency Service, Hospital
Feasibility studies
Female
Gelatinase
Hospitalization
Humans
Inhalation
Lipocalin
Lipocalin-2 - blood
Male
Mathematical models
Middle Aged
Model accuracy
Neurotoxicity Syndromes - blood
Neutrophils
Parameters
Poisoning
Prediction models
Retrospective Studies
Tertiary Care Centers
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Summary:This study aimed to assess the feasibility of using the plasma neutrophil gelatinase-associated lipocalin (NGAL) level at the time of presentation in the emergency department (ED) to predict acute kidney injury (AKI) and the long-term neurological outcomes of acute charcoal-burning carbon monoxide (CO) poisoning. This retrospective study included 260 patients who suffered acute charcoal-burning CO poisoning. The median plasma NGAL concentration at the time of presentation in the ED after acute charcoal-burning CO poisoning was 78 (54–115) ng/ml. The NGAL level was an independent predictor of AKI development and could be used to stratify the severity of AKI. However, the area under the receiver operating characteristic curve (AUC) of the predictive model for AKI that included both the plasma NGAL level and clinical parameters was comparable to that of the predictive model including only the clinical parameters. The plasma NGAL level at the time of presentation in the ED was an independent factor predicting long-term neurological outcomes in patients who did not develop AKI. In these patients, the plasma NGAL level significantly improved the predictive accuracy of the model when used in combination with clinical parameters. In contrast, the plasma NGAL level was not associated with long-term neurological outcomes in patients who developed AKI. Measurement of the plasma NGAL level at the time ED presentation might improve the prediction of long-term neurological outcomes in patients who do not develop AKI after acute charcoal-burning CO poisoning. However, it might not offer additional benefit for AKI prediction compared to previously used markers.
ISSN:0960-3271
1477-0903
DOI:10.1177/0960327119851259