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 4

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


	Good neurological outcome ()	PNO ()	Risk factor for PNO	Crude OR (95% CI) for PNO	value

Baseline data
Age, years	59.2 ± 16.4	61.0 ± 14.7	Age ≥ 60 years	1.32 (0.75 to 2.32)	0.339
Weight (kg)^a ()	83.0 (75.0 to 93.3)	85.0 (75.0 to 90.0)	Weight ≥ 85 kg	1.28 (0.69 to 2.36)	0.428
Male (sex)	87 (87.9)	78 (81.3)	Female sex	1.67 (0.76 to 3.69)	0.200
Witnessed CA^a ()	94 (95.9)	75 (78.1)	Unwitnessed CA	6.58 (2.17 to 20.00)	<0.001
Bystander CPR	86 (86.9)	85 (88.5)	Not bystander CPR	0.86 (0.36 to 2.02)	0.722
ROSC time (min)^a ()	22.5 (12.0 to 29.0)	30.0 (23.0 to 40.0)	Time to ROSC ≥ 25 min	3.16 (1.63 to 6.10)	0.001
Initial VF/VT^a ()	82 (83.7)	46 (48.4)	Not initial VF/VT	5.46 (2.79 to 10.67)	<0.001
SAPS II (score)	67.8 ± 10.4	73.1 ± 9.9	SAPS II score ≥ 69	2.01 (1.13 to 3.56)	0.017

Admission day
Diuresis (L/day)	2.03 (1.77 to 2.86)	1.81 (1.43 to 2.50)	Diuresis < 1.93 L/day	1.98 (1.12 to 3.50)	0.018
Fluid balance (L/day)	3.97 (2.58 to 5.64)	4.80 (3.46 to 6.45)	Fluid balance ≥ 4.45 L/day	2.07 (1.17 to 3.66)	0.012
S-Creatinine (μ·mol/L)	96.0 (84.0 to 113.0)	107.5 (94.0 to 139.3)	S-Creatinine ≥ 101 μ·mol/L	1.90 (1.08 to 3.36)	0.026
S-Urea (mmol/L)	6.3 (5.3 to 7.8)	7.1 (5.7 to 9.6)	S-Urea ≥ 6.7 mmol/L	1.90 (1.08 to 3.36)	0.026
B-HCO₃⁻ (mmol/L)	20.6 (18.9 to 22.6)	19.0 (17.1 to 21.2)	B-HCO₃⁻ < 19.0 mmol/L	2.58 (1.42 to 4.71)	0.002
B-BE (mmol/L)	−5-6 (−8.2 to −3.6)	−8.5 (−12.0 to −6.0)	B-BE < −7.0 mmol/L	4.18 (2.30 to 7.68)	<0.001
B-Lactate (mmol/L)	2.8 (1.6 to 5.4)	5.1 (3.1 to 9.1)	B-Lactate ≥ 4.1 mmol/L	2.68 (1.50 to 4.77)	0.001
SOFA (score)	10.0 (9.0 to 11.0)	11.0 (10.0 to 12.0)	SOFA score ≥ 10	3.66 (1.85 to 7.24)	<0.001

Urine biomarkers ( at admission and at day three)
Adm. β2M (ng/mL)	1458 (346 to 5356)	4172 (1117 to 8616)	Adm. β2M ≥ 2769 ng/mL	2.25 (1.27 to 3.99)	0.005
Day 3 β2M (ng/mL)^a	630 (110 to 4945)	570 (66 to 4598)	Day 3 β2M ≥ 627 ng/mL	1.00 (0.54 to 1.84)	0.986
Adm. osteopontin, ng/mL	1871 (1266 to 2570)	2293 (1841 to 3151)	Adm. osteopontin ≥2068 ng/mL	2.35 (1.32 to 4.17)	0.003
Day 3 osteopontin (ng/mL)^a	1344 (570 to 2648)	2239 (1270 to 4148)	Day 3 osteopontin ≥1683 ng/mL	2.60 (1.38 to 4.91)	0.003
Adm. TFF3 (ng/mL)	1982 (858 to 3743)	3400 1827 to 5110)	Adm. TFF3, ng/mL ≥ 2694 ng/mL	2.35 (1.32 to 4.17)	0.003
Day 3 TFF3 (ng/mL)^a	2447 (961 to 3820)	3695 (2163 to 5622)	Day 3 TFF3, ng/mL ≥ 2910 ng/mL	3.07 (1.62 to 5.84)	0.001

Outcome
Hospital RRT	2 (2.0)	6 (6.3)	Treatment with RRT	3.28 (0.64 to 16.39)	0.137
AKI within 3 days	29 (29.3)	59 (61.5)	Presence of AKI	3.85 (2.12 to 6.94)	<0.001
Dead at 6 months	0 (0.0)	88 (91.7)	Death		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. PNO: poor neurological outcome defined as cerebral performance category (CPC) 3–5; 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; n.a.: not applicable. ^aData from some patients are missing.