scholarly journals Performance Assessment of the Universal Vital Assessment Score vs Other Illness Severity Scores for Predicting Risk of In-Hospital Death Among Adult Febrile Inpatients in Northern Tanzania, 2016-2019

2021 ◽  
Vol 4 (12) ◽  
pp. e2136398
Author(s):  
John P. Bonnewell ◽  
Matthew P. Rubach ◽  
Deng B. Madut ◽  
Manuela Carugati ◽  
Michael J. Maze ◽  
...  
2018 ◽  
Vol 24 (8) ◽  
pp. 1223-1233 ◽  
Author(s):  
Stephen Statz ◽  
Giselle Sabal ◽  
Amanda Walborn ◽  
Mark Williams ◽  
Debra Hoppensteadt ◽  
...  

It has been well established that angiopoietin 2 (Ang-2), a glycoprotein involved in activation of the endothelium, plays an integral role in the pathophysiology of sepsis and many other inflammatory conditions. However, the role of Ang-2 in sepsis-associated coagulopathy (SAC) specifically has not been defined. The aim of this study was to measure Ang-2 plasma levels in patients with sepsis and suspected disseminated intravascular coagulation (DIC) in order to demonstrate its predictive value in SAC severity determination and 28-day mortality outcome. Plasma samples were collected from 102 patients with sepsis and suspected DIC at intensive care unit (ICU) admission. The Ang-2 plasma levels were quantified using a sandwich enzyme-linked immunosorbent assay method. The International Society on Thrombosis and Haemostasis DIC scoring system was used to compare the accuracy of Ang-2 levels versus clinical illness severity scores in predicting SAC severity. Mean Ang-2 levels in patients with sepsis and DIC were significantly higher in comparison to healthy controls ( P < 0.0001), and median Ang-2 levels showed a downward trend over time ( P = 0.0008). Baseline Ang-2 levels and clinical illness severity scores were higher with increasing severity of disease, and Ang-2 was a better predictor of DIC severity than clinical illness scores. This study demonstrates that Ang-2 levels are significantly upregulated in SAC, and this biomarker can be used to risk stratify patients with sepsis into non-overt DIC and overt DIC. Furthermore, the Ang-2 level at ICU admission in a patient with sepsis and suspected DIC may provide a predictive biomarker for mortality outcome.


2020 ◽  
Vol 49 (1) ◽  
pp. 524-524
Author(s):  
Carly Schmidt ◽  
Alexis Thompson ◽  
Sarah Welsh ◽  
Darlene Simas ◽  
Patricia Carreiro ◽  
...  

2013 ◽  
Vol 28 (5) ◽  
pp. 885.e1-885.e8 ◽  
Author(s):  
Antoine G. Schneider ◽  
Miklós Lipcsey ◽  
Michael Bailey ◽  
David V. Pilcher ◽  
Rinaldo Bellomo

2007 ◽  
Vol 16 (4) ◽  
pp. 378-383 ◽  
Author(s):  
Michelle E. Kho ◽  
Ellen McDonald ◽  
Paul W. Stratford ◽  
Deborah J. Cook

Background Despite widespread use of the Acute Physiology and Chronic Health Evaluation II (APACHE II), its interrater reliability has not been well studied. Objective To determine interrater reliability of APACHE II scores among 1 intensive care nurse and 2 research clerks. Methods In a prospective, blinded, observational study, 3 raters collected APACHE II scores on 37 consecutive patients in a medical-surgical intensive care unit. One research clerk was blinded to the study’s start date to minimize observer bias. The nurse and the other research clerk were blinded to each other’s scores and did not communicate with the first research clerk about the study. The data analyst was blinded to the identity and source of all 3 raters’ scores. Intraclass correlation coefficients and 95% confidence intervals were assessed. Results Mean (standard deviation) APACHE II scores were 21.8 (9.2) for the nurse, 20.4 (7.7) for research clerk 1, and 20.5 (8.1) for research clerk 2. Among the 3 raters, the intraclass correlation coefficient (95% confidence interval) was 0.90 (0.84, 0.94) for the APACHE II total score. Within APACHE II score components, the highest reliability was for age (0.98 [0.97, 0.99]), with lower reliabilities for the Chronic Health Index (0.64 [0.50, 0.80]) and the verbal component of the Glasgow Coma Scale (0.40 [0.20, 0.60]). Results were similar between pairs of raters. Conclusions Use of trained nonmedical personnel to collect illness severity scores for clinical, research, and administrative purposes is reasonable. This method could be used to assess reliability of other illness severity scores.


1994 ◽  
Vol 3 (4) ◽  
pp. 267-272 ◽  
Author(s):  
JL Osteyee ◽  
W Banner

BACKGROUND: Gastric bleeding in children is associated with critical illness, shock, and physical trauma. Histamine-2 receptor antagonist therapy is used prophylactically to treat gastric bleeding, but it is not known whether bolus dosing or continuous infusion dosing is more effective. OBJECTIVES: To compare the effects of continuous infusion intravenous ranitidine and intravenous bolus dosing of ranitidine on gastric pH in critically ill children and to look for correlation between illness severity scores and gastric pH. METHODS: Sixteen critically ill children were randomized into two groups. Children in group 1 received bolus dosing on day 1 and continuous infusion of ranitidine on day 2. Group 2 received the continuous infusion on day 1 and bolus dosing on day 2. Equivalent doses of ranitidine were based on weight. Continuous infusion regimen: ranitidine bolus of 0.15 mg/kg followed by continuous infusion at 0.15 mg/kg per hour for 12 hours. Bolus regimen: 1 mg/kg, two doses 6 hours apart. Pediatric risk of mortality scores were recorded upon admission to the study. RESULTS: There was no statistically significant difference between regimens. Both raised gastric pH values above 4.0 during the treatment phase. There was no correlation between illness severity scores and gastric pH values. CONCLUSIONS: Both bolus dosing and continuous infusion dosing of 4 mg/kg per day of intravenous ranitidine were effective at raising and maintaining gastric pH in critically ill children.


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