Publication:
Predictive Value of the Aspartate Aminotransferase to Platelet Ratio Index for Parenteral Nutrition–Associated Cholestasis in Premature Infants With Intestinal Perforation

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Issued Date

2018

Resource Type

Article

File Type

application/pdf

ISSN

1486071

DOI

10.1177/0148607117722755

Other identifier(s)

2-s2.0-85045892482

Rights Holder(s)

Scopus

Bibliographic Citation

Journal of Parenteral and Enteral Nutrition. Vol 42, No.4 (2018), p.797-804

Suggested Citation

Vongbhavit K., Underwood M.A. Predictive Value of the Aspartate Aminotransferase to Platelet Ratio Index for Parenteral Nutrition–Associated Cholestasis in Premature Infants With Intestinal Perforation. Journal of Parenteral and Enteral Nutrition. Vol 42, No.4 (2018), p.797-804. doi:10.1177/0148607117722755 Retrieved from: https://hdl.handle.net/20.500.14740/5592

Title

Predictive Value of the Aspartate Aminotransferase to Platelet Ratio Index for Parenteral Nutrition–Associated Cholestasis in Premature Infants With Intestinal Perforation

Author(s)

Vongbhavit K.
 Underwood M.A.

Abstract

Background: Parenteral nutrition–associated cholestasis (PNAC) is a major cause of morbidity and mortality in premature infants. Early predictors of PNAC would have clinical value. We sought to evaluate risk factors and liver function testing as predictors of PNAC in premature infants with intestinal perforation. Methods: Medical records of infants with a gestational age <34 weeks, birth weight <2000 g, and intestinal perforation due to either necrotizing enterocolitis or spontaneous intestinal perforation were reviewed. We analyzed clinical data and the maximum values of the aspartate aminotransferase (AST) to platelet ratio index (APRI), alanine aminotransferase (ALT), AST to ALT ratio, and total bilirubin (TB). Results: Sixty infants were identified, 17 infants with PNAC and 43 infants without PNAC. Sepsis, time to initiation of enteral feeds after perforation, and duration of PN were associated with PNAC. Within 2 weeks following intestinal perforation, APRI, ALT, and TB each differed significantly between infants who later developed PNAC and those that did not. The best APRI cut-point was 0.4775 within 2 weeks after perforation (area under the receiver operating characteristic curve, 0.90; positive predictive value, 85%; and negative predictive value, 87%); the cut-point for ALT was 13.5 (0.90, 85%, 84%), and the cut-point for TB was 3.55 (0.82, 69%, 83%), respectively, at 2 weeks after perforation. AST to ALT ratio did not differ between groups. Conclusions: APRI and ALT had reasonable predictive value for PNAC in premature infants with intestinal perforation, with the APRI the best predictor within 2 weeks after perforation. © 2017 American Society for Parenteral and Enteral Nutrition

Subject(s)

Alanine aminotransferase
 Aspartate aminotransferase
 Bilirubin
 Alanine aminotransferase
 Aspartate aminotransferase
 Bilirubin
 Alanine aminotransferase level
 Apgar score
 Article
 Aspartate aminotransferase level
 Aspartate aminotransferase to platelet ratio index
 Bilirubin blood level
 Birth weight
 Bloodstream infection
 Cholestasis
 Clinical outcome
 Cohort analysis
 Controlled study
 Diagnostic test accuracy study
 Disease severity
 Enteric feeding
 Female
 Gestational age
 Hospitalization
 Human
 Intestine function
 Intestine perforation
 Length of stay
 Liver function test
 Major clinical study
 Male
 Medical record
 Metabolism parameters
 Necrotizing enterocolitis
 Parenteral nutrition
 Predictive value
 Prematurity
 Priority journal
 Retrospective study
 Risk factor
 Sensitivity and specificity
 Small for date infant
 Adverse event
 Blood
 Cholestasis
 Intestine perforation
 Liver
 Liver disease
 Metabolism
 Newborn
 Newborn disease
 Parenteral nutrition
 Pathology
 Prematurity
 Sepsis
 Thrombocyte
 Very low birth weight
 Alanine Transaminase
 Aspartate Aminotransferases
 Bilirubin
 Birth Weight
 Blood Platelets
 Cholestasis
 Female
 Gestational Age
 Humans
 Infant, Newborn
 Infant, Newborn, Diseases
 Infant, Premature
 Infant, Very Low Birth Weight
 Intestinal Perforation
 Liver
 Liver Diseases
 Liver Function Tests
 Male
 Parenteral Nutrition
 Risk Factors
 Sepsis

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URI

https://hdl.handle.net/20.500.14740/5592

Collections

Scopus: Year 1983-2021

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