Mortality prediction at admission to intensive care: A comparison of microalbuminuria with acute physiology scores after 24 hours

摘要: Objective: To compare low level albumin excretion (microalbuminuria), a marker of systemic capillary permeability, with mortality, Acute Physiologic And Chronic Health Evaluation (APACHE II) score, the Simplified (SAP and their derived mortality probabilities in patients admitted to general intensive care unit. Design: Prospective observational study. Setting: A 14-bed unit university teaching hospital. Patients: total 140 consecutive (59 surgical, 48 medical, 22 trauma, 11 burns). Interventions: Urine collection within 15 mins admission for assessment microalbuminuria. Measurements Main Results: Microalbuminuria, expressed as albumin-creatinine ratio (ACR: normal, 5.9 mg/mmol gave sensitivity death 100%, specificity 59%, positive predictive value 25%, negative 100%. Mortality probability receiver operator characteristic curve areas ACR, APACHE II, SAP II were 0.843 (p < .0001), 0.793 =.0004), 0.770 =.0017), respectively. ACR was associated stay =.0021) highest serum C-reactive protein =.0002), creatinine <.0001), bilirubin =.0009). For medical patients, whom 34 survived, ACRs survivors nonsurvivors 8.3 (5.7-10.8) 10.7 (4.1-48.2) mg/mmol, respectively =.32). but not score significantly higher nonsurvivors. Conclusions: burn microalbuminuria predicted well scores calculated after 24 hrs, it shows promise predictor outcome.