PP087 [Post PICU » Patient outcomes]: ASSOCIATION OF URINARY 8-HYDROXY-2’DEOXYGUANOSINE LEVELS WITH MORTALITY AND SEVERITY OF ILLNESS IN CRITICALLY SICK CHILDREN

Abstract

BACKGROUND AND AIM: Critically sick children have increased risk of mortality due to multi-organ failure. Increased oxidative stress may be one of the reasons for extensive cellular damage and death during critical illness. 8-hydroxy-2'deoxyguanosine (8-OHdG) is a DNA(deoxyribonucleic acid) oxidation product and can be used as a marker of severity of illness and mortality. Aim is to study the association of urinary 8-OHdG levels with mortality and severity of illness in critically sick children. METHOD:In this single center cross-sectional study, 88 critically sick children aged between 1 month and 18 years were enrolled. Urinary 8-OHdG levels were measured for each patient within 24 hours of admission in pediatric intensive care unit (PICU). Severity of illness was recorded at PICU admission using the PEdiatric Logistic Organ Dysfunction-2 (PELOD-2) score. Urinary 8-OHdG levels were analyzed in relation to PICU mortality and PELOD-2 score.RESULTS: Urinary 8-OHdG levels were higher in nonsurvivors as compared to survivors. ROC curve analysis for the association between urinary 8-OHdG levels and PICU mortality gave an area under the curve value of 0.626 which has satisfactory discriminatory power. Ideal 8-OHdG level cut off was 21.38, sensitivity was 50% and specificity was 72%. Pearson correlation coefficient between PELOD-2 score and urinary 8-OHdG levels was poor. [r=0.192(p-value=0. 074)]CONCLUSIONS: There is increased DNA oxidative damage in non-survivors. The discriminatory power of urinary 8-OHdG levels is just satisfactory in predicting mortality in critically sick children. There is poor correlation of urinary 8-OHdG levels and severity of illness, which limits its use as a tool for monitoring illness severity.