The Prognosis of Pediatric Intensive Care Unit Patients Can Be Affected by Gamma Glutamyl transferase and Uric Acid Levels: A systematic review with Meta-Analysis.

Abstract

Abstract Background: Elevated Gamma Glutamyl transferase (GGT) and uric acid levels have been associated with worse outcomes in critically ill patients, but their predictive value in Pediatric Intensive Care Unit (PICU) patients is unclear. We conducted a systematic review and meta-analysis to evaluate the association between GGT/uric acid and mortality in PICU patients. Methods: PubMed, Embase and Cochrane Library were searched for observational studies examining the association between GGT/uric acid levels and mortality in PICU patients. Pooled risk ratios (R.R.) with 95% confidence intervals (CI) were calculated using random-effects models. Results: 8 studies with 2,134 patients were included. Elevated GGT was associated with significantly higher mortality risk (RR 1.86, 95% CI 1.34-2.58). The association remained significant when restricted to multivariate analyses (RR 1.95, 95% CI 1.17-3.26). Elevated uric acid levels were also associated with higher mortality (RR 1.97, 95% CI 1.33-2.90). Significant heterogeneity was present. Conclusions: Elevated Gamma Glutamyl transferase (GGT) and uric acid levels are associated with higher mortality risk in Pediatric Intensive Care Unit (PICU) patients. These biomarkers may assist in risk stratification, although additional studies are needed to confirm these findings.