Relationship between aspartate aminotransferase to platelet ratio index and liver injury in pediatric sepsis

Background Sepsis-associated liver injury (SALI) is one of the main clinical manifestations of sepsis, as well as an independent risk factor for multiple organ dysfunction syndrome and mortality in pediatric sepsis. The early warning biomarkers for identifying SALI remain poorly defined. Objectiv...

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Main Authors: Robby Godlief, Dzulfikar Djalil Lukmanul Hakim, Dwi Prasetyo
Format: Article
Language:English
Published: Indonesian Pediatric Society Publishing House 2021-06-01
Series:Paediatrica Indonesiana
Subjects:
Online Access:https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2611
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author Robby Godlief
Dzulfikar Djalil Lukmanul Hakim
Dwi Prasetyo
author_facet Robby Godlief
Dzulfikar Djalil Lukmanul Hakim
Dwi Prasetyo
author_sort Robby Godlief
collection DOAJ
description Background Sepsis-associated liver injury (SALI) is one of the main clinical manifestations of sepsis, as well as an independent risk factor for multiple organ dysfunction syndrome and mortality in pediatric sepsis. The early warning biomarkers for identifying SALI remain poorly defined. Objective To analyze the relationship between aspartate aminotransferase to platelet ratio index (APRi) and liver injury occurrence in pediatric sepsis, as well as determine the APRi cutoff value for early identification of SALI. Methods This retrospective study used secondary data derived from January 2019 to August 2020. The study population comprised admitted children aged 1 month to <18 years who met the criteria for sepsis, and had aspartate aminotransferase (AST) and platelet laboratory parameters checked in the first 24 hours of sepsis and before administration of antibiotics. Pearson’s Chi-square test was used to analyze for correlations. Estimation of the APRi cutoff value in the early occurrence of SALI was performed with logistic regression analysis and receiver operating characteristic (ROC) curve. Results Of the 112 subjects, 94.6% were categorized as having septic shock and 48.2% had SALI. Logistic regression revealed that APRi was a significant predictor of SALI, as indicated by cut-off 4.726 [OR 1.098; 95%CI 1.002 to1.203; P=0.045]. The area under the curve (AUC) was 0.831 or 83.1%, which was classified as strong (80-90%). Conclusion The APRi is a reliable early predictor of SALI in pediatric sepsis, as indicated by an increase in APRi (> 4.726) within the first 24 hours of sepsis.
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spelling doaj.art-96371cec4e704e71a3eb02594842752b2022-12-21T19:57:37ZengIndonesian Pediatric Society Publishing HousePaediatrica Indonesiana0030-93112338-476X2021-06-016131495410.14238/pi61.3.2021.149-542611Relationship between aspartate aminotransferase to platelet ratio index and liver injury in pediatric sepsisRobby Godlief0Dzulfikar Djalil Lukmanul Hakim1Dwi Prasetyo2Padjadjaran UniversityDepartment of Child Health, Universitas Padjadjaran Medical School/ Dr. Hasan Sadikin General Hospital, Bandung, West JavaDepartment of Child Health, Universitas Padjadjaran Medical School/ Dr. Hasan Sadikin General Hospital, Bandung, West JavaBackground Sepsis-associated liver injury (SALI) is one of the main clinical manifestations of sepsis, as well as an independent risk factor for multiple organ dysfunction syndrome and mortality in pediatric sepsis. The early warning biomarkers for identifying SALI remain poorly defined. Objective To analyze the relationship between aspartate aminotransferase to platelet ratio index (APRi) and liver injury occurrence in pediatric sepsis, as well as determine the APRi cutoff value for early identification of SALI. Methods This retrospective study used secondary data derived from January 2019 to August 2020. The study population comprised admitted children aged 1 month to <18 years who met the criteria for sepsis, and had aspartate aminotransferase (AST) and platelet laboratory parameters checked in the first 24 hours of sepsis and before administration of antibiotics. Pearson’s Chi-square test was used to analyze for correlations. Estimation of the APRi cutoff value in the early occurrence of SALI was performed with logistic regression analysis and receiver operating characteristic (ROC) curve. Results Of the 112 subjects, 94.6% were categorized as having septic shock and 48.2% had SALI. Logistic regression revealed that APRi was a significant predictor of SALI, as indicated by cut-off 4.726 [OR 1.098; 95%CI 1.002 to1.203; P=0.045]. The area under the curve (AUC) was 0.831 or 83.1%, which was classified as strong (80-90%). Conclusion The APRi is a reliable early predictor of SALI in pediatric sepsis, as indicated by an increase in APRi (> 4.726) within the first 24 hours of sepsis.https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2611pediatricsepsisaspartate aminotransferase to platelet ration indexsesis-associated liver injuryaprisali
spellingShingle Robby Godlief
Dzulfikar Djalil Lukmanul Hakim
Dwi Prasetyo
Relationship between aspartate aminotransferase to platelet ratio index and liver injury in pediatric sepsis
Paediatrica Indonesiana
pediatric
sepsis
aspartate aminotransferase to platelet ration index
sesis-associated liver injury
apri
sali
title Relationship between aspartate aminotransferase to platelet ratio index and liver injury in pediatric sepsis
title_full Relationship between aspartate aminotransferase to platelet ratio index and liver injury in pediatric sepsis
title_fullStr Relationship between aspartate aminotransferase to platelet ratio index and liver injury in pediatric sepsis
title_full_unstemmed Relationship between aspartate aminotransferase to platelet ratio index and liver injury in pediatric sepsis
title_short Relationship between aspartate aminotransferase to platelet ratio index and liver injury in pediatric sepsis
title_sort relationship between aspartate aminotransferase to platelet ratio index and liver injury in pediatric sepsis
topic pediatric
sepsis
aspartate aminotransferase to platelet ration index
sesis-associated liver injury
apri
sali
url https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2611
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AT dzulfikardjalillukmanulhakim relationshipbetweenaspartateaminotransferasetoplateletratioindexandliverinjuryinpediatricsepsis
AT dwiprasetyo relationshipbetweenaspartateaminotransferasetoplateletratioindexandliverinjuryinpediatricsepsis