Urinary liver-type fatty acid-binding protein variation as a predictive value of short-term mortality in intensive care unit patients

• Published in: Renal failure 2021-01, Vol.43 (1), p.1041-1048
• Main Authors: Suzuki, Ginga, Ichibayashi, Ryo, Yamamoto, Saki, Serizawa, Hibiki, Nakamichi, Yoshimi, Watanabe, Masayuki, Honda, Mitsuru
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biomarkers - urine; Clinical Study; Critical care; Critical Illness - mortality; critically ill; Fatty acid-binding protein; Fatty Acid-Binding Proteins - urine; Fatty acids; Female; Humans; ICU; Intensive care; Intensive Care Units; L-FABP; Lactic acid; Liver; liver-type fatty acid-binding protein; Male; Middle Aged; Mortality; Multivariate Analysis; Odds Ratio; Patients; Predictive Value of Tests; Prognosis; Prospective Studies; Time Factors; Variation
• ISSN: 0886-022X; 1525-6049
• DOI: 10.1080/0886022X.2021.1943439

Predicting the prognosis of intensive care unit (ICU) patients is crucial because it may lead to patient stratification that would in turn help in appropriately distributing limited medical resources. This study, therefore, aimed to investigate the use of the urinary liver-type fatty acid-binding protein (L-FABP) semi-quantitative kit in rapidly predicting the prognosis of patients admitted to the ICU. We conducted a single-center, prospective, observational study wherein 100 consecutive patients admitted to the ICU with an indwelling bladder catheter were enrolled between April and October 2020. Urine specimens were collected at the time of admission (T1) and after 6 h (T2), and urinary L-FABP levels were semi-quantitatively measured. Based on the results, an L-FABP variation was defined as the change in L-FABP (negative, weakly positive, or strongly positive) from T1 to T2. Patients were divided into three groups (L-FABP decreased group, unchanged group, or increased group), following which we compared their 14-day mortality. Finally, a total of 79 patients were included in the analysis. In multivariate analysis, urinary L-FABP variation [Odds ratio (OR) = 14.327, 95% confidence interval (CI) = 1.819-112.868, p = 0.01] and lactate (OR = 1.234, 95%CI = 1.060-1.437, p = 0.01) were significantly associated with 14-day mortality. Urinary L-FABP variation at 6 h after admission was significantly associated with 14-day mortality.