Serial Evaluation of the SOFA Score to Predict Outcome in Critically Ill Patients

Ferreira, Flavio Lopez; Bota, Daliana Peres; Bross, Annette; Mélot, Christian; Vincent, Jean‐Louis

doi:10.1001/jama.286.14.1754

Cited by 2,352 publications

(1,962 citation statements)

References 21 publications

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“…Severity of illness at ICU admission was assessed using the acute physiology and chronic health evaluation (APACHE) version II score [21]. Severity of illness during ICU admission was estimated daily with the sequential organ failure (SOFA) score [22,23]. We further recorded daily the use of physical restraints at any moment during the preceding day, defined from 10 A.M. to 10 A.M.…”

Section: Data Collectionmentioning

confidence: 99%

Intensive care unit environment may affect the course of delirium

et al. 2012

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Purpose: Delirium is a common disorder in intensive care unit (ICU) patients. It is unclear whether ICU environment affects delirium. We investigated the influence of ICU environment on the number of days with delirium during ICU admission. Methods: In this prospective before-after study, ICU delirium was compared between a conventional ICU with wards and a single-room ICU with, among others, improved daylight exposure. We included patients admitted for more than 24 h between March and June 2009 (ICU with wards) or between June and September 2010 (single-room ICU). Patients who remained unresponsive throughout ICU admission were excluded. The presence of delirium in the preceding 24 h was assessed daily with the confusion assessment method for the ICU (CAM-ICU) by research physicians combined with evaluation of medical and nursing charts. The number of days with delirium was investigated with Poisson regression analysis. Results: We included 55 patients (449 observation days) in the ICU with wards and 75 patients (468 observation days) in the single-room ICU. After adjusting for confounding, the number of days with delirium decreased by 0.4 days (95 % confidence interval 0.1-0.7) in the singleroom ICU (p = 0.005). The incidence of delirium during ICU stay was similar in the ICU with wards (51 %) and in the single-room ICU (45 %, p = 0.53). Conclusions: This study is the first to show that ICU environment may influence the course of delirium in ICU patients.

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Section: Data Collectionmentioning

confidence: 99%

Intensive care unit environment may affect the course of delirium

et al. 2012

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“…Encouraging results have also been obtained in cancer patients requiring renal replacement therapy for acute renal failure, even in case of multiple organ failure or in combination with ventilatory support [33][34][35][36] . While renal replacement therapy was unequivocally associated with a 90-95% ICU mortality in case of multiple organ failure two decades ago 12,18 , Soares et al 31 recently reported 65% six month mortality in patients with one or two associated organ failures and a 93% six month mortality in case of 3 associated organ failures, again similar to general ICU patients 32 . Moreover, in a study by Benoit et al comparing the six-month survival between critically ill patients with and without hematological malignancy, the presence of an underlying hematological malignancy was not independently related with six-month survival once accounting for the severity of illness upon ICU admission or the duration of hospitalization prior to admission 33 .…”

Section: Outcome In Critically Ill Cancer Patients: Evolution Over Thmentioning

confidence: 97%

“…The high mortality of more than 80% in patients requiring mechanical ventilation (Table 1) [8][9][10][11][12][13][14][15] , increasing to more than 90% to 95% in patients developing multiple organ failure or who require renal replacement therapy during ICU stay 12,[16][17][18] , particularly in the transplant setting [19][20][21] , together with the severe emotional burden endured by these patients and their relatives, and the considerable costs of advanced and prolonged life-supporting therapy 13 resulted in a general reluctance to admit such patients to the ICU 2,6,7 . However, over the past few years, several centres throughout the world have been reporting on increasingly improving survival in critically ill patients with hematological malignancies and solid tumors [22][23][24][25][26][27][28][29][30][31] , approaching survival rates reported in general ICU patients 32 . In a case-historical control study 22 , Azoulay et al reported a four-fold lower risk of death in cancer patients who required mechanical ventilation between 1996 and 1998 as compared with 1990-1995.…”

Section: Outcome In Critically Ill Cancer Patients: Evolution Over Thmentioning

confidence: 99%

Outcome in critically ill cancer patients: past and present

Benoît¹,

Depuydt²

2008

Rev. bras. ter. intensiva

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RESUMO JUSTIFICATIVA E OBJETIVOS: Até o final do século passado, havia grande incerteza quanto a propriedade de internar pacientes com câncer em unidades de terapia intensiva (UTI) para medidas de suporte avançado. Contudo, ao longo dos últimos anos, vários centros ao redor do mundo têm reportado aumento significativo da sobrevida de tais pacientes. O objetivo deste estudo foi rever os principais artigos publicados nas duas últimas décadas, com foco na melhoria do prognóstico de pacientes com câncer criticamente enfermos. CONTEÚDO: Realizou-se uma busca bibliográfica no sistema MedLine -PubMed (www.pubmed.gov) para identificar artigos em linguagem inglesa sobre cuidados intensivos no pacientes com tumores sólidos ou neoplasias hematológicas, com ênfase no prognóstico e no tratamento. Utilizaram-se os seguintes unitermos: cancer, solid tumor, hematologic or hematological malignancies, immunosupression, ICU, ventilation, organ failure, sepsis and infection. Estudos referenciados nos artigos selecionados na busca também foram utilizados. CONCLUSÕES: O tema será abordado de forma sistematizada. Inicialmente, haverá uma discussão sobre o prognóstico sombrio experimentado por estes pa-

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“…Di antara manfaat tersebut yaitu manfaat dalam penentuan pengambilan keputusan oleh tenaga medis dan keluarga, menentukan bentuk pendekatan dan perawatan yang terbaik bagi pasien, serta antisipasi dan alokasi dari penggunaan alat bantu (obat vasopresor, ventilator, dan hemodialisas) atau sumber daya lainnya. 14,15 Oleh karena itu, penelitian ini dilakukan dengan cara analisis kesintasan pada pasien sepsis berat berdasarkan perbedaan bersihan laktat. Dengan demikian, diharapkan hasil penelitian ini dapat digunakan untuk memberikan informasi klinis bagi tenaga medis, keluarga, dan pengambil keputusan lainnya untuk menentukan bentuk pendekatan tata laksana terbaik pada pasien, serta antisipasi dari keluaran yang mungkin terjadi.…”

Section: Pendahuluanunclassified

Peran Bersihan Laktat pada Kesintasan Pasien Sepsis Berat

Hambali¹,

Chen²,

Widodo³

et al. 2016

JPDI

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ABSTRAKPendahuluan. Sepsis Berat merupakan masalah kesehatan dengan tingkat mortalitas yang tinggi serta insiden yang terus meningkat. Bersihan laktat menggambarkan kinetika metabolisme anaerob pasien sepsis berat dan merupakan parameter yang potensial untuk mengevaluasi kondisi penyakit dan intervensi pengobatan yang didapat pasien. Namun demikian, hubungan antara bersihan laktat terhadap terjadinya kematian pasien sepsis berat belum diketahui. Berdasarkan hal tersebut, penelitian ini dilakukan untuk mengetahui pengaruh bersihan laktat terhadap kesintasan pasien dengan sepsis berat, serta faktor-faktor perancu yang mempengaruhi hubungan tersebut.Metode. Penelitian ini merupakan penelitian kohort prospektif yang dilaksanakan di Unit Gawat Darurat dan ruang perawatan Rumah Sakit dr. Cipto Mangunkusumo (RSCM) pada bulan Maret-Mei 2011. Pasien termasuk dalam kelompok bersihan laktat tinggi bila terdapat perbedaan kadar laktat ≥10% dalam 6 jam pertama pengobatan, sedangkan perbedaan <10% termasuk ke dalam kelompok bersihan laktat rendah. Selanjutnya, dilakukan observasi terhadap terjadinya kematian dalam 10 hari pertama perawatan pada kedua kelompok. Data yang terkumpul selanjutnya dianalisis mengunakan uji statistik log-rank test, serta dicari nilai hazard ratio dengan menggunakan uji cox regression model. Selanjutnya, dilakukan analisis variabel perancu dengan menggunakan uji cox regression.Hasil. Laju kesintasan kelompok bersihan laktat tinggi dan rendah masing-masing sebesar 60,0% dan 26,7% (p=0,004). Median kesintasan yaitu 3 hari pada bersihan laktat rendah, sedangkan kematian tidak mencapai 50% pada bersihan laktat tinggi. Interkuartil I kedua kelompok berturut-turut sebesar 1 dan 4 hari. Dari analisis didapatkan hazard ratio sebesar 2,87 (IK 95%; 1,41-5,83). Pada analisis multivariat keberadaan syok sepsis, skor SOFA, penggunaan vasopresor/inotropik, transfusi dan cairan resusitasi, tidak ada yang mengubah nilai hazard ratio >10%. Oleh karena itu, tidak ada yang memenuhi syarat untuk disebut sebagai perancu.Simpulan. Pasien bersihan laktat tinggi memiliki kesintasan lebih tinggi dibandingkan pasien bersihan laktat rendah dan hubungan tersebut tidak dipengaruhi perancu.

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Serial Evaluation of the SOFA Score to Predict Outcome in Critically Ill Patients

Cited by 2,352 publications

References 21 publications

Intensive care unit environment may affect the course of delirium

Intensive care unit environment may affect the course of delirium

Outcome in critically ill cancer patients: past and present

Peran Bersihan Laktat pada Kesintasan Pasien Sepsis Berat

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