Background
The Cardiac Surgery-Associated Neutrophil Gelatinase-Associated Lipocalin (CSA-NGAL)
score has been developed to stratify patients with cardiac surgery-associated acute
kidney injury (CSA-AKI). Its predictive power needs to be validated to guide clinical
decision for such high-risk patients.
Methods
A prospective study was conducted on 637 consecutive adult patients who developed
postoperative AKI after cardiac surgery with cardiopulmonary bypass. AKI was defined
according to Kidney Disease: Improving Global Outcomes criteria (KDIGO). The CSA-NGAL
score was calculated. Assessment of the diagnostic performance of the scoring model
was performed by area under the receiver operating curve analysis.
Results
The area under the curve for the postoperative Urinary NGAL showed an area under the
curve ([standard error (SE)] 0.80 (0.38); p<0.001; 95% CI 0.72–0.87). Its sensitivity
for CSA-AKI in the first 24 hours was 66% and specificity was 80% (cut-off value 300.1
ng/mL). There was a positive correlation between NGAL score and KDIGO criteria, with
a significant increase in postoperative mean Urinary NGAL values as the KDIGO stage
increased.
Conclusion
The CSA-NGAL score has a high sensitivity, specificity and positive predictive value
that can translate into improved outcomes and resource allocation. It is believed
that adding it to the existing clinical scoring systems for AKI prediction will be
productive.
Keywords
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Article info
Publication history
Published online: July 01, 2021
Accepted:
May 6,
2021
Received in revised form:
March 16,
2021
Received:
January 21,
2021
Identification
Copyright
© 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
