Risk Value of Urinary Neutrophil Gelatinase-Associated Lipocalin and Interleukin-6 Levels on Severe Fluid Overload in Patients After Cardiac Surgery
Objective To analyze the risk value of urinary neutrophil gelatinase-associated lipocalin(NGAL)and interleukin-6(IL-6)levels on severe fluid overload(FO)in patients after cardiac surgery.Methods A total of 220 patients underwent cardiac surgery in The Third People's Hospital of Chengdu from April 2020 to March 2023 were enrolled.Patients with FO≥10％were classified into group A and FO＜10％into group B according to FO within 24 h after surgery.General data were analyzed and urinary NGAL and IL-6 levels were compared before and after surgery.Logistic regression model was used to analyze risk factors for severe FO after surgery.ROC curve was plotted to analyze the risk value of urinary NGAL and IL-6 on severe FO.The influence of different primary diseases on FO was analyzed by subgroups.Results The proportion of male patients and stay time in ICU were higher in group A than group B(P＜0.05),while the preoperative albumin level and urine volume the day after surgery were lower(P＜0.05).There was no significant difference in body mass index,age,course of disease,operation time,urine volume during operation,primary disease types,preoperative left ventricular ejection fraction,creatinine,leukocytes,hemoglobin,mechanical ventilation time,extracorporeal circulation time,intraoperative urine volume,the proportion of acute kidney injury,left cardiac insufficiency,hypertension,heart failure and diabetes between the two groups(P＞0.05).Urinary NGAL and IL-6 levels of two groups were increased(P＜0.05)at 2 h and 12 h after surgery,not only the higher at 12 h than 2 h(P＜0.05),but also the higher in group A than group B before surgery,after surgery and 12 h after surgery(P＜0.05).Logistic results showed high urinary NGAL and IL-6 levels before operation were risk factors for severe FO in patients after cardiac surgery(P＜0.05).ROC results showed the optimal cut-off point of preoperative NGAL and IL-6 levels on severe FO after surgery was 48.04 ng/mL and 32.26 pg/mL,with the AUC of 0.865,0.704 respectively and 0.894 for their combined detection.There was no difference in FO,ICU stay time,cardiopulmonary bypass time,urine volume the day after operation and preoperative NGAL and IL-6 among the subgroups of coronary,congenital and valvular heart diseases(all P＞0.05).Conclusion Urinary NGAL and IL-6 were abnormally elevated in patients after cardiac surgery,the levels of which before surgery could be risk factors for severe FO.
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