Critical Care Research and Practice

Clinical Study

Urine β-2-Microglobulin, Osteopontin, and Trefoil Factor 3 May Early Predict Acute Kidney Injury and Outcome after Cardiac Arrest

Table 3

Univariate analyses of risk factors for mortality in resuscitated, comatose out-of-hospital cardiac arrest patients.


	Survivors ()	Nonsurvivors ()	Risk factor for mortality	Crude OR (95% CI) for mortality	value

Baseline data
Age (years)	59.1 ± 13.1	61.4 ± 14.1	Age ≥ 60 years	1.37 (0.77 to 2.41)	0.283
Weight (kg)^a ()	83.0 (75.0 to 93.0)	85.0 (75.0 to 90.0)	Weight ≥ 85 kg	1.35 (0.73 to 2.51)	0.335
Male (sex)	94 (87.9)	71 (80.7)	Female sex	1.73 (0.79 to 3.80)	0.167
Witnessed CA^a ()	101 (95.3)	68 (77.3)	Unwitnessed CA	5.94 (2.13 to 16.59)	<0.001
Bystander CPR	94 (87.9)	77 (87.5)	Not bystander CPR	1.03 (0.44 to 2.44)	0.941
ROSC time (min)^a ()	19.0 (12.0 to 29.0)	30.0 (23.0 to 44.0)	Time to ROSC ≥ 25 min	3.28 (1.68 to 6.40)	<0.001
Initial VF/VT^a ()	86 (81.1)	42 (48.3)	Not initial VF/VT	4.61 (2.42 to 8.76)	<0.001
SAPS II (score)	68.3 ± 10.4	73.0 ± 10.0	SAPS II score ≥ 69	1.62 (0.91 to 2.87)	0.099

Admission day
Diuresis (L/day)	2.03 (1.75 to 2.84)	1.81 (1.43 to 2.45)	Diuresis < 1.93 L/day	1.99 (1.12 to 3.53)	0.018
Fluid balance (L/day)	4.05 (2.37 to 5.74)	4.75 (3.50 to 6.39)	Fluid balance ≥ 4.45 L/day	1.92 (1.08 to 3.39)	0.025
S-Creatinine (μ·mol/L)	98.0 (84.0 to 114.0)	107.5 (94.3 to 140.0)	S-Creatinine ≥ 101 μ·mol/L	1.76 (1.00 to 3.11)	0.051
S-Urea (mmol/L)	6.3 (5.1 to 7.7)	7.3 (5.8 to 9.7)	S-Urea ≥ 6.7 mmol/L	1.93 (1.09 to 3.43)	0.023
B-HCO₃⁻ (mmol/L)	20.6 (18.9 to 22.4)	19.0 (16.6 to 21.2)	B-HCO₃⁻ < 19.0 mmol/L	2.82 (1.55 to 5.14)	0.001
B-BE (mmol/L)	−5.7 (−8.4 to −3.7)	−8.8 (−12.4 to −6.0)	B-BE < −7.0 mmol/L	3.51 (1.94 to 6.35)	<0.001
B-Lactate (mmol/L)	3.3 (1.7 to 5.9)	5.2 (2.9 to 9.3)	B-Lactate ≥ 4.1 mmol/L	2.48 (1.39 to 4.43)	0.002
SOFA (score)	10.0 (8.0 to 11.0)	11.0 (10.0 to 12.0)	SOFA score ≥ 10	4.26 (2.07 to 8.75)	<0.001

Urine biomarkers ( at admission and at day three)
Adm. β2M (ng/mL)	1840 (361 to 5356)	4840 (1117 to 9415)	Adm. β2M ≥ 2769 ng/mL	2.27 (1.28 to 4.05)	0.005
Day 3 β2M (ng/mL)^a	628 (90 to 4678)	617 (67 to 4884)	Day 3 β2M ≥ 627 ng/mL	1.04 (0.56 to 1.95)	0.898
Adm. osteopontin (ng/mL)	1876 (1334 to 2588)	2553 (1814 to 3251)	Adm. osteopontin ≥ 2068 ng/mL	1.99 (1.12 to 3.53)	0.018
Day 3 osteopontin (ng/mL)^a	1345 (590 to 2539)	2386 (1317 to 4397)	Day 3 osteopontin ≥ 1683 ng/mL	2.69 (1.41 to 5.15)	0.002
Adm. TFF3 (ng/mL)	2010 (1066 to 3964)	3400 (1827 to 5110)	Adm. TFF3, ng/mL ≥ 2694 ng/mL	2.17 (1.22 to 3.85)	0.008
Day 3 TFF3 (ng/mL)^a	2447 (1045 to 987)	3784 (2384 to 5969)	Day 3 TFF3, ng/mL ≥ 2910 ng/mL	3.61 (1.86 to 7.02)	<0.001

Outcome
Hospital RRT	3 (2.8)	5 (5.7)	Treatment with RRT	2.09 (0.48 to 9.01)	0.314
AKI within 3 days	32 (29.9)	56 (63.6)	Presence of AKI	4.10 (2.52 to 7.46)	<0.001
PNO at 6 months	8 (7.5)	88 (100.0)	Poor neurological outcome		n.a.

Categorical data are presented as number (percent), continuous data with skewed distribution as median (interquartile range), and continuous data with normal distribution as mean (±standard deviation). Presented values are from univariate Pearson’s chi square analysis. OR: odds ratio; CI: confidence interval; : number; CA: cardiac arrest; CPR: cardiopulmonary resuscitation; ROSC: return of spontaneous circulation; VF/VT: ventricular fibrillation/ventricular tachycardia; SAPS: simplified acute physiology score; S: serum; B: whole blood; HCO₃⁻: bicarbonate; BE: base excess; SOFA: sequential organ failure assessment; Adm.: admission; β2M: β-2-microglobulin; TFF3: trefoil factor 3; RRT: renal replacement therapy; AKI: acute kidney injury; PNO: poor neurological outcome defined as cerebral performance category (CPC) 3–5; n.a.: not applicable. ^aData from some patients are missing.