Prediction of ICU mortality in critically ill children

Ramazani, Jamileh; Hosseini, Mohammad Bagher

doi:10.1007/s00063-018-0484-0

Cited by 21 publications

(20 citation statements)

References 22 publications

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“…The findings of several studies are consistent with our findings have been cited that lower GCS score was significantly accompanying with poor prognosis or higher mortality rate (4,5,12,23). Okazaki et al…”

Section: Discussionsupporting

confidence: 93%

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Comparison of Glasgow Coma Scale and GCS-Age Prognosis Score in Older Adult Patients

Ramazani¹,

Hosseini²

2019

Yoğun Bakım Derg

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Background: Recent data have shown that the proportion of older adult patients admitted to intensive care units is increased and the severity of illness is an independent risk factor associated with mortality. The aim of the current study was to compare the prognostic value of the Glasgow Coma Scale (GCS) and GCS-Age Prognosis (GAP) scores in older adult patients (aged ≥65 years) admitted to Medical Intensive Care Unit (MICU). Methods: This was a prospective study of 168 consecutive older adult patients admitted to medical ICU during a 14-month period. For each patient, the GCS and GAP score in the first 24hours of admission and demographic characteristics were calculated and recorded. For statistical analysis, the logistic regression, Receiver operator characteristic (ROC) curve, and Hosmer-Lemeshow test were used (95% confidence interval). Results: Survivors had a significantly higher GCS and GAP scores in the first 24h of MICU admission compared with nonsurvivors (p<0.001, p<0.001, respectively). The discrimination power of both models was good ((area under curve [AUC]:83.8% (standard error [SE]:3%), AUC: 85.4% (SE: 2.9%), respectively). Based on the Hosmer-Lemeshow goodness of fit test, just GCS had an acceptable calibration (x2=13.18, p=0.068). Conclusions: For older adult patients admitted to the MICU, GCS and GAP scores reliably predict outcomes. Based on AUCs the discrimination power of models was good, but the calibration was acceptable just for GCS, thus the GCS is the better predictive model than GAP and useful in determining the prognosis of older adult patients in MICU.

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Section: Discussionsupporting

confidence: 93%

“…Although it has become the gold standard of describing the level of consciousness. Decreasing GCS score (ranging from 3-15) is associated with a worsening level of consciousness and poor prognosis (3,4). The GCS-Age Prognosis (GAP) score is defined as age/GCS (5).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Glasgow Coma Scale and GCS-Age Prognosis Score in Older Adult Patients

Ramazani¹,

Hosseini²

2019

Yoğun Bakım Derg

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“…Our study showed that, GCS was significantly lower among died cases than among lived cases. This is in agreement with [18] who found that, The nonsurvivors showed significantly lower values for GCS than survivors .…”

Section: Discussionsupporting

confidence: 93%

Sequential Organ Failure Assessment [SOFA] Score in the Pediatric Intensive

Sayed¹,

Haie²,

Shehata³

2018

Benha Journal of Applied Sciences

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Estimation of disease severity and probability of death are important elements in determining the prognosis of patients in ICU. It has been a consistent observation that in pediatric intensive care unit children usually experience multiple organ dysfunction syndromes [MODS]. Sequential organ failure assessment [SOFA] score is based on MODS and help in predicting outcome in critically ill children The aim of this work was to test the value of a pediatric version of SOFA score [pSOFA] in a cohort of critically ill children admitted into the pediatric intensive care unit. Our study was conducted at the pediatric intensive care unit, Pediatric Hospital, Benha University and Benha children hospital. Fifty critically ill patients were included in our study. All patients were subjected to medical history, clinical examination and laboratory investigations. Calculation of pSOFA score was measured. sex was almost equal among the studied cases. Regarding etiology of the studied cases. Septic shock and respiratory failure were the most frequent etiologies. Mean value of Hb was low and a high significant decrease in platelets count among cases.overall mortality rate was 28%.GCS was significantly lower among died cases than among lived cases.The value of pSOFA score was significantly higher among nonsurvived than survived cases [13.5,5.5 respectively]. Total pSOFA ≥9.0 had highest diagnostic characteristics in prediction of death.Pediatric SOFA score [pSOFA] score can be used as a reliable prognostic predictor of mortality among PICU patients.

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“…SOFA score was currently used for organ failure score and was widely used for the prognosis prediction of critically ill patients. [33][34][35] A study including 173 out-of-hospital CPR patients treated with hypothermia found that the higher the SOFA score, the higher the mortality rate and the worse neurological function during hospitalization. 36 MFP can be used to investigate whether the relationship between covariables and independent variables is nonlinear.…”

Section: F I G U R E 1 the Roc Curve Of The Predictive Modelmentioning

confidence: 99%

Development a clinical prediction model of the neurological outcome for patients with coma and survived 24 hours after cardiopulmonary resuscitation

Wang

Tang

Zhang

et al. 2020

Clinical Cardiology

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Background Cardiac arrest is still a global public health problem at present. The neurological outcome is the core indicator of the prognosis of cardiac arrest. However, there is no effective means or tools to predict the neurological outcome of patients with coma and survived 24 hours after successful cardiopulmonary resuscitation (CPR). Hypothesis Therefore, we expect to construct a prediction model to predict the neurological outcome for patients with coma and survived 24 hours after successful CPR. Methods A retrospective cohort study was used to construct a prediction model of the neurological function for patients with coma and survived 24 hours after successful CPR. From January 2007 to December 2015, a total of 262 patients met the inclusion and exclusion criteria. Results The predictive model was developed using preselected variables by a systematic review of the literature. Finally, we get five sets of models (three sets of construction models and two sets of internal verification models) which with similar predictive value. The stepwise model, which including seven variables (age, noncardiac etiology, nonshockable rhythm, bystander CPR, total epinephrine dose, APTT, and SOFA score), was the simplest model, so we choose it as our final predictive model. The area under the ROC curve (AUC), specificity, and sensitivity of the stepwise model were respectively 0.82 (0.77, 0.87), 0.72and 0.82. The AUC, specificity, and sensitivity of the bootstrap stepwise (BS stepwise) model were respectively 0.82 (0.77, 0.87), 0.71, and 0.82. Conclusion This new and validated predictive model may provide individualized estimates of neurological function for patients with coma and survived 24 hours after successful CPR using readily obtained clinical risk factors. External validation studies are required further to demonstrate the model's accuracy in diverse patient populations.

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Prediction of ICU mortality in critically ill children

Cited by 21 publications

References 22 publications

Comparison of Glasgow Coma Scale and GCS-Age Prognosis Score in Older Adult Patients

Comparison of Glasgow Coma Scale and GCS-Age Prognosis Score in Older Adult Patients

Sequential Organ Failure Assessment [SOFA] Score in the Pediatric Intensive

Development a clinical prediction model of the neurological outcome for patients with coma and survived 24 hours after cardiopulmonary resuscitation

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