Comparison of Sepsis-related Organ Failure Assessment (SOFA) score and CIS (cellular injury score) for scoring of severity for patients with multiple organ dysfunction syndrome (MODS)

Oda, Shigeto; Hirasawa, Hiroyuki; Sugai, Takeshi; Shiga, Hidetoshi; Nakanishi, Koji; Kitamura, Nobuto; Sadahiro, Tomohito; Hirano, Takeshi

doi:10.1007/s001340000710

Cited by 52 publications

(27 citation statements)

References 17 publications

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“…The infections were determined to be communityacquired pneumonia, acute pyelonephritis, acute intraabdominal infection, and primary bacteremia. The degree of sepsis was evaluated by using the SOFA score [15]. Additional information is available in the Electronic Supplementary Material (ESM) [16][17][18].…”

Section: Methodsmentioning

confidence: 99%

Prognostic significance of hypothalamic–pituitary–adrenal axis hormones in early sepsis: a study performed in the emergency department

et al. 2014

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Section: Methodsmentioning

confidence: 99%

Prognostic significance of hypothalamic–pituitary–adrenal axis hormones in early sepsis: a study performed in the emergency department

et al. 2014

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“…This state is called systemic inflammatory response syndrome (1,2). The incidence of sepsis is extremely high in the intensive care unit (ICU), with a mortality of ≤40-80%.…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine protects against acute kidney injury through downregulating inflammatory reactions in endotoxemia rats

et al. 2015

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Abstract. Approximately 42% of patients with sepsis undergo acute kidney injury (AKI), which evidently influences patient survival. However, effective therapy strategies are lacking, thus, the present study investigated the protective effects of dexmedetomidine (DEX), a highly selective α-2 adrenoceptor agonist, in rat sepsis models. Rat sepsis models were generated through lipopolysaccharide injection (LPS; 5 mg/kg) in the tail vein. Rats were pretreated with DEX (10 µg/kg) 10 min before LPS injection to observe its protective effects. Of note, a unique α-2-adrenergic receptor antagonist, yohimbine (YOH; 1 mg/kg, intraperitoneally), was also used to antagonize the protective effects of DEX 30 min before DEX exposure. Thirty-two male Sprague Dawley rats were randomly divided into the Sham, LPS, DEX + LPS and YOH + DEX + LPS groups (n=8/group). All the rats were sacrificed 4 h later to observe the pathological changes of renal tissue, including plasma creatinine (Cr), blood urea nitrogen (BUN), kidney injury molecule-1 (KIM-1) and high mobility group protein 1 (HMGB-1) expression. Interleukin 6 (IL-6), IL-18 and tumor necrosis factor α (TNF-α) were all determined to examine the mechanisms of LPS-induced AKI relative to inflammatory reaction. The results indicated that AKI induced by LPS was serious. Renal pathological injury, plasma Cr, BUN, IL-6, IL-18 and TNF-α were all evidently increased in varying degrees. KIM-1 and HMGB-1 expression was upregulated in the LPS group (P<0.05 vs. Sham group). However, when rats were pretreated with DEX, AKI induced by LPS was decreased significantly. Renal pathological injury, plasma Cr, BUN, IL-6, IL-18, TNF-α, and KIM-1 and HMGB-1 expression were all reduced (P<0.05 vs. LPS group). In addition, exposure of the α-2-adrenergic receptor antagonist, YOH, eliminated this reduction. In conclusion, DEX protected against sepsis-induced AKI through depressing the inflammatory reaction, mechanisms of which may be associated with α-2 receptors inhibition. IntroductionSepsis, also called septicemia, is a serious complication of patients undergoing pathogen infection, trauma, burn, hypoxia, reperfusion injury and surgery, which could affect myocardial contractility, decreased organ oxygen uptake capacity, and can lead to septic shock and multiple organ dysfunction syndrome. This state is called systemic inflammatory response syndrome (1,2). The incidence of sepsis is extremely high in the intensive care unit (ICU), with a mortality of ≤40-80%. As reported, the kidney is one of the most susceptible target organs of sepsis (3). Approximately 50% of patients suffer from acute kidney injury (AKI) caused by sepsis. Notably, mortality of these patients is as high as 70% (4,5). However, the mechanisms of sepsis-induced AKI remain unclear and effective therapy strategies are also lacking.Inflammatory factors, such as interleukin 6 (IL-6), IL-18 and tumor necrosis factor α (TNF-α), play an important role in the pathological and physiological process, particularly IL-18. As recently reported, IL-1...

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“…Several studies have shown that there are significant differenc es in the value of the SOFA and ElebuteStoner score for differentiation of mor tality or MODS. Oda et al [31] had sim ilar cutoff values at admission with ours, with a higher sensitivity and specificity (71.3 and 76.9%, respectively); however, they focused on MODS. Another study by Moreno et al [30] that included 1,449 interdisciplinary ICU patients, found an AUC of 0.847 and 0.772 for the for the maximum SOFA score on admission.…”

Section: Scoring In Cardiogenic Shockmentioning

confidence: 48%

Predictive value of outcome scores in patients suffering from cardiogenic shock complicating AMI

Kellner

Prondzinsky

Pallmann

et al. 2013

Med Klin Intensivmed Notfmed

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Acute myocardial infarction (AMI) is complicated by cardiogenic shock (CS) in 7-10% of cases and the mortality rate is about 60-70% [13,16]. Early revascula rization by percutaneous coronary inter vention (PCI) and intensive care includ ing positive inotropic agents, vasopres sors, and circulatory assist devices are routinely used to improve cardiac output and to prevent multiorgan failure [1,5,16]. Intraaortic balloon pump (IABP) is a commonly used mechanical support sys tem for patients with CS [25,33]. Despite intensive therapy, these patients often de velop a systemic inflammatory response syndrome (SIRS) progressing to multiple organ dysfunction syndrome (MODS) and subsequent death due to multiple or gan failure [6,39]. Identification of these patients in the ICU is clinically important [34]. Previous studies of patients with MODS or sepsis have shown the rele vance of several scoring systems such as the APACHE II [22,42,43] Originalien culation is more complex and laborious. However, a scoring system is only valid for a special group of patients when it has been validated on this group. The objec tive of the present study was to evaluate the predictive value of the APACHE II, APACHE III, Elebute-Stoner, SOFA, and SAPS II scores on mortality, determined on the day of diagnosis/admission of infarctionrelated CS patients and at the point of maximum value. Methods Inclusion and exclusion criteriaPatients treated with primary PCI for CS secondary to AMI, who required inotro pic and/or vasopressor support despite appropriate volume filling, were includ ed in the study. For the diagnosis of CS, the definitions of Hochman et al. [16] and Reynolds et al. [36] were used. The inclu sion and exclusion criteria are shown in . Tab. 1. Study designIn this prospective observational study, carried out in a medical intensive care unit of a university hospital from 2004 to 2005, we consecutively enrolled 45 pa tients in CS. Patients underwent regu lar clinical assessment, complete inva sive monitoring, and frequent blood sam pling for laboratory markers. Datasets for the APACHE II, APACHE III, ElebuteStoner, SOFA, and SAPS II scores and for the patient parameters were calcu lated. Written informed consent was ob tained from all patients or their relatives. The trial was approved by the local eth ics committee. Primary endpointsThe primary endpoint was the value of the initial and the maximum value of the APACHE II, APACHE III, ElebuteStoner, SOFA, and SAPS II scores in pre dicting mortality. Scores were collected at enrollment and then daily for 4 days. Demographic data, admission diagnosis, mechanical ventilation, IABP use, hemo dynamic parameters, survivors, and non survivors were recorded. The APACHE II, APACHE III, Elebute-Stoner, SOFA, and SAPS II scores were determined by the worst value found during the initial 24 h after ICU admission and also by the max imum value during the following 96 h.A flowchart of the study is shown in . Fig. 1. Coronary angiography and PCICoronary angiography and PCI were per formed using...

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Comparison of Sepsis-related Organ Failure Assessment (SOFA) score and CIS (cellular injury score) for scoring of severity for patients with multiple organ dysfunction syndrome (MODS)

Cited by 52 publications

References 17 publications

Prognostic significance of hypothalamic–pituitary–adrenal axis hormones in early sepsis: a study performed in the emergency department

Prognostic significance of hypothalamic–pituitary–adrenal axis hormones in early sepsis: a study performed in the emergency department

Dexmedetomidine protects against acute kidney injury through downregulating inflammatory reactions in endotoxemia rats

Predictive value of outcome scores in patients suffering from cardiogenic shock complicating AMI

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