scholarly journals Association between APACHE II score and nosocomial infections in intensive care unit patients: A multicenter cohort study

Author(s):  
Machi Suka ◽  
Katsumi Yoshida ◽  
Jun Takezawa
2019 ◽  
Vol 52 (4) ◽  
pp. 277-285
Author(s):  
Marcus Vinícius Ferraz De Lucena ◽  
Marcelo Antônio Oliveira Santos-Veloso ◽  
Geylson Rodrigo dos Santos Xavier ◽  
Inácio Borges Ferreira ◽  
Felipe de Castro Moraes ◽  
...  

Study design: a descriptive, prospective cohort study. Objectives: identify the risk factors associated with SAPS 3 and APACHE II score to improve mortality prediction in elderly admitted in the intensive care unit (ICU). Methodology: a cohort study with 174 elderly patients admitted in ICU from July 2016 to June 2017. The primary independent variables analyzed were: presence of stress hyperglycemia, the need for invasive mechanical ventilation (IMV), acute renal failure, level of consciousness and use of vasopressors. The outcomes studied were death and hospital discharge. Results: ICU and hospital mortality were 17.8% and 29.8%, respectively. The multivariate analysis of factors associated with hospital death not contemplated in the obtaining of SAPS 3 demonstrated that IMV, Chronic Obstructive Pulmonary Disease (COPD) and Mean Arterial Pressure (MAP) <70 mmHg improved the prediction of mortality. The Hosmer-Lemeshow test (p=0.472) and area under ROC curve=0.80 (CI95%:0.731-0.872) confirmed, respectively, an appropriate calibration and acceptable-to-excellent discriminatory power for this model. IMV and COPD were also factors associated with the APACHE II score in prediction of mortality with appropriated calibration (p=0.471) and acceptable-to-excellent discriminatory power (area under ROC curve=0.80 [CI95%:0.730-0.868]). Conclusion: IMV, COPD, and MAP <70 mmHg were associated with SAPS3 and APACHE II to predict mortality in elderly admitted to ICU.


2015 ◽  
Vol 30 (5) ◽  
pp. 1055-1060 ◽  
Author(s):  
Robert S. Green ◽  
Alexis F. Turgeon ◽  
Lauralyn A. McIntyre ◽  
Alison E. Fox-Robichaud ◽  
Dean A. Fergusson ◽  
...  

2018 ◽  
Vol 46 (3) ◽  
pp. 1254-1262 ◽  
Author(s):  
Surat Tongyoo ◽  
Tanuwong Viarasilpa ◽  
Chairat Permpikul

Objective To compare the outcomes of patients with and without a mean serum potassium (K+) level within the recommended range (3.5–4.5 mEq/L). Methods This prospective cohort study involved patients admitted to the medical intensive care unit (ICU) of Siriraj Hospital from May 2012 to February 2013. The patients’ baseline characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, serum K+ level, and hospital outcomes were recorded. Patients with a mean K+ level of 3.5 to 4.5 mEq/L and with all individual K+ values of 3.0 to 5.0 mEq/L were allocated to the normal K+ group. The remaining patients were allocated to the abnormal K+ group. Results In total, 160 patients were included. Their mean age was 59.3±18.3 years, and their mean APACHE II score was 21.8±14.0. The normal K+ group comprised 74 (46.3%) patients. The abnormal K+ group had a significantly higher mean APACHE II score, proportion of coronary artery disease, and rate of vasopressor treatment. An abnormal serum K+ level was associated with significantly higher ICU mortality and incidence of ventricular fibrillation. Conclusion Critically ill patients with abnormal K+ levels had a higher incidence of ventricular arrhythmia and ICU mortality than patients with normal K+ levels.


1994 ◽  
Vol 27 (2) ◽  
pp. 191
Author(s):  
Kyoung Min Lee ◽  
Gie Hoan Lee ◽  
Dae Ja Um ◽  
Ryoung Choi

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Christian S. Michel ◽  
Daniel Teschner ◽  
Irene Schmidtmann ◽  
Matthias Theobald ◽  
Beate Hauptrock ◽  
...  

AbstractPatients undergoing allogeneic hematopoietic stem cell transplantation have a high morbidity and mortality, especially after admission to intensive care unit (ICU) during peri-transplant period. The objective of this study was to identify new clinical and biological parameters and validate prognostic scores associated with ICU, short-and long-term survival. Significant differences between ICU survivors and ICU non-survivors for the clinical parameters invasive mechanical ventilation, urine output, heart rate, mean arterial pressure, and amount of vasopressors have been measured. Among prognostic scores (SOFA, SAPSII, PICAT, APACHE II, APACHE IV) assessing severity of disease and predicting outcome of critically ill patients on ICU, the APACHE II score has shown most significant difference (p = 0.002) and the highest discriminative power (area under the ROC curve (AUC) 0.74). An elevated level of lactate at day of admission was associated with poor survival on ICU and the most significant independent parameter (p < 0.001). In our cohort kidney damage with low urine output has a highly relevant impact on ICU, short- and long-term overall survival. The APACHE II score was superior predicting ICU mortality compared to all other tested prognostic scores for patients on ICU during peri-transplant period.


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