Urinary L-FABP as a mortality predictor in <5-year-old children with sepsis in Bangladesh

Pediatr Int. 2016 Mar;58(3):185-191. doi: 10.1111/ped.12765. Epub 2015 Nov 6.


Background: Although sepsis is often associated with high mortality in severely malnourished children, data are very limited on appropriate diagnostic tools to predict mortality. We examined the role of urinary liver-type fatty acid-binding protein (L-FABP) in children <5 years old with sepsis who died.

Methods: This prospective observational study was conducted at the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh. Children aged 6-59 months admitted with sepsis from April 2010 to December 2011 were enrolled. Comparison of clinical and laboratory characteristics was made between children who survived (n = 83) and those who did not survive (n = 22).

Results: On multiple Poisson regression analysis, after adjusting for potential confounders such as mid-upper arm circumference < 115 mm, plasma albumin < 2.5 g/dL, potassium > 5.0 mmol/L, and blood urea nitrogen > 20 mg/dL on admission, first urine L-FABP ≥ 370 ng/mL (relative risk [RR], 2.76; 95%CI: 1.22-6.25), weight-for-length/height z score < -3 (RR, 2.54; 95%CI: 1.26-5.09), capillary refilling time > 2.0 s (RR, 5.16; 95%CI: 1.46-18.3), and sodium > 160 mmol/L (RR, 2.72; 95%CI: 1.07-6.90) were identified as significant risk factors of mortality in children with sepsis. Diagnostic performance of first urine L-FABP was analyzed using receiver operating characteristic curve, and the area under the curve was 0.647 (95%CI: 0.500-0.795).

Conclusion: Urinary L-FABP may be a useful predictor of mortality in septic children. Urinary examination is non-invasive and easy to apply at the bedside.

Keywords: case fatality; mortality; sepsis; severe acute malnutrition; urinary liver-type fatty acid-binding protein.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bangladesh / epidemiology
  • Biomarkers / urine
  • Child, Preschool
  • Disease Progression
  • Fatty Acid-Binding Proteins / urine*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Prospective Studies
  • ROC Curve
  • Risk Factors
  • Sepsis / mortality
  • Sepsis / urine*
  • Survival Rate / trends


  • Biomarkers
  • FABP1 protein, human
  • Fatty Acid-Binding Proteins