scholarly journals SEPSIS-3.0 – Ist die Intensivmedizin bereit für die ICD-11?

2021 ◽  
Author(s):  
Thomas Schmoch ◽  
Michael Bernhard ◽  
Andrea Becker-Pennrich ◽  
Ludwig Christian Hinske ◽  
Josef Briegel ◽  
...  
Keyword(s):  
Septic Shock ◽  
International Classification Of Diseases ◽  
International Consensus ◽  
The Third ◽  
Failure Assessment ◽  
High Care ◽  
Classification Of Diseases ◽  
Qsofa Score ◽  
Sepsis And Septic Shock

Zusammenfassung Hintergrund Im Januar 2022 wird die 11. Revision der International Classification of Diseases (ICD-11) in Kraft treten. Unter anderem wird darin die SEPSIS-3-Definition implementiert sein, in der Sepsis als „lebensbedrohliche Organdysfunktion, hervorgerufen durch eine fehlregulierte Wirtsantwort auf eine Infektion“ definiert wird. Ziel der vorliegenden Sekundärauswertung einer Umfrage zum Thema „Sepsis-induzierte Koagulopathie“ war es zu evaluieren, ob die SEPSIS-3-Definition (engl. The Third International Consensus Definitions for Sepsis and Septic Shock) 4 Jahre nach ihrer internationalen Einführung im klinischen Alltag anästhesiologisch geführter Intensivstationen in Deutschland angekommen ist und so die Voraussetzungen für die Verwendung des ICD-11 gegeben sind. Methoden Im Rahmen einer deutschlandweiten Umfrage unter ärztlichen Leitern von Intensivstationen, die zwischen Oktober 2019 und Mai 2020 durchgeführt wurde, wurde in einem gesonderten Fragenblock nach der verwendeten Sepsisdefinition gefragt. Zusätzlich wurde gefragt, ob der quick-Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) Score zum Screening auf Sepsis in dem Krankenhaus, zu dem die teilnehmende Intensivstation gehört, verwendet wird. Ergebnisse Insgesamt nahmen 50 ärztliche Leiter von anästhesiologisch geführten Intensivbereichen an der Umfrage teil. In Summe gaben die ausgewerteten Intensivstationen an, etwa 14,0 % der in Deutschland registrierten High-Care-Betten zu führen. An 78,9 % der Universitätsklinika und 84,0 % der teilnehmenden Lehrkrankenhäuser ist die SEPSIS-3-Definition im klinischen Alltag integriert. Im Gegensatz dazu wird der Screening-Test „qSOFA“ nur von 26,3 % der teilnehmenden Universitätsklinika, aber immerhin von 52,0 % der Lehrkrankenhäuser und 80,0 % der „sonstigen“ Krankenhäuser verwendet. Schlussfolgerung Unsere Daten zeigen, dass sowohl SEPSIS‑3 als auch qSOFA im klinischen Alltag deutscher Krankenhäuser angekommen sind. Die zurückhaltende Verwendung des qSOFA an Universitätsklinika bei gleichzeitiger breiter Akzeptanz der SEPSIS-3-Definition kann als Indiz interpretiert werden, dass die Suche nach einem geeigneten Screeningtest für Sepsis noch nicht abgeschlossen ist.

scholarly journals Analisis Hubungan Sequential Organ Failure Assessment (Sofa) Score Dengan Mortalitas Pasien Sepsis

2020 ◽  
Vol 9 (2) ◽  
pp. 168
Author(s):  
Agustin Iskandar ◽  
Fran Siska
Keyword(s):  
Septic Shock ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
Area Under The Curve ◽  
International Consensus ◽  
The Third ◽  
Failure Assessment ◽  
Sepsis And Septic Shock

Sepsis merupakan kondisi disfungsi organ mengancam nyawa yang diakibatkan oleh disregulasi sistem imun pejamu terhadap infeksi dan Sequential Organ Failure Assessment (SOFA) score merupakan suatu skoring untuk menilai kegagalan organ terkait sepsis. Peningkatan SOFA score diasosiasikan dengan outcome pasien yang lebih buruk.  Tujuan: Menganalisis korelasi SOFA score dengan mortalitas pada pasien sepsis. Metode: Desain penelitian adalah kohort prospektif yang dilakukan di RSU Dr Saiful Anwar dari Maret 2018 hingga Juni 2019. Kriteria diagnosis sepsis ditegakkan berdasarkan The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Perhitungan SOFA score dilakukan dalam 2 hari pertama perawatan pasien sepsis di rumah sakit. Analisis data dilakukan pada p < 0,05. Hasil: Didapatkan 85 pasien sepsis dengan luaran meninggal sebanyak 72,94% sedangkan 28,06% membaik. Terdapat perbedaan bermakna antara SOFA score yang meninggal dan yang hidup (p=0,015).  SOFA score dipakai untuk memprediksi kematian, didapatkan area under the curve (AUC) 0,74 (p=0,009), dengan cut off point optimum 7. Pada total SOFA score lebih tinggi dari sama dengan 7, didapatkan RR= 3.8, p=0.028. SOFA score merupakan parameter untuk menilai kegagalan organ pada pasien sepsis, dimana total SOFA score yang lebih tinggi dikaitkan dengan peningkatan risiko kematian. Simpulan: SOFA score pada kelompok yang meninggal lebih tinggi daripada yang sembuh. Pasien sepsis dengan SOFA score lebih besar sama dengan 7 memiliki risiko 3,8 kali lebih besar untuk meninggal.Kata kunci: risiko kematian, sepsis, SOFA score

What's in a Name?

2013 ◽  
Vol 51 (2) ◽  
pp. 113-116 ◽  
Author(s):  
Marc J. Tassé
Keyword(s):  
Mental Retardation ◽  
Intellectual Disability ◽  
World Health Organization ◽  
International Classification Of Diseases ◽  
World Health ◽  
International Consensus ◽  
The World ◽  
Classification Of Diseases ◽  
Health Organization

Abstract The World Health Organization (WHO) is in the process of developing the 11th edition of the International Classification of Diseases (ICD–11). Part of this process includes replacing mental retardation with a more acceptable term to identify the condition. The current international consensus appears to be replacing mental retardation with intellectual disability. This article briefly presents some of the issues involved in changing terminology and the constraints and conventions that are specific to the ICD.

Clinical and psychopathological characteristics of sexual dysfunctions and non-psychotic mental disorders in women

2021 ◽  
Vol LIII (2) ◽  
pp. 42-45
Author(s):  
Alexander V. Martusenko ◽  
Elena O. Boyko ◽  
Olga G. Zaitseva
Keyword(s):  
Mental Disorders ◽  
Diagnostic Criteria ◽  
Inpatient Treatment ◽  
International Classification Of Diseases ◽  
Sexual Disorders ◽  
Sexual Dysfunctions ◽  
Second Stage ◽  
The Third ◽  
Classification Of Diseases

Aim. Study of clinical and psychopathological characteristics in women with sexual dysfunctions and mental disorders of the psychotic level. Material and methods. Clinical-psychopathological and sexological methods were used in the work. The results were processed using the licensed program Statistica 10.0 for Windows. At the first stage, 134 women (mean age 43.115.3 years) were examined who had inpatient treatment in the department for persons with non-psychotic mental disorders. At the second stage, the study involved 89 women (mean age 35.212.2 years), who were diagnosed with sexual dysfunctions. Results. Clinical and psychopathological indicators were studied, clinical, psychopathological and sexological analysis of sexual dysfunctions in women with non-psychotic mental disorders was carried out, taking into account the diagnostic criteria of the International Classification of Diseases-10. Three groups of patients were identified: (1) a group of women with sexual dysfunctions caused by non-psychotic mental disorders; (2) a group of patients in whom non-psychotic mental disorders were formed against the background of primary sexual pathology; (3) a group of patients in whom non-psychotic mental disorders accompany sexual dysfunctions. Conclusions. Sexual disorders in the studied groups are characterized by the predominance of libido disorder in the first group and the second group, as well as the predominance of dyspareunia in the third. There were no significant differences in the duration of sexual dysfunctions in the groups, which must be taken into account when choosing therapeutic and rehabilitation measures.

scholarly journals Acute Kidney Injury and In-Hospital Mortality: A Retrospective Analysis of a Nationwide Administrative Database of Elderly Subjects in Italy

2019 ◽  
Vol 8 (9) ◽  
pp. 1371 ◽  
Author(s):  
Fabbian ◽  
Savriè ◽  
De Giorgi ◽  
Cappadona ◽  
Di Simone ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
International Classification Of Diseases ◽  
Administrative Database ◽  
Elderly Subjects ◽  
Dialysis Treatment ◽  
The Third ◽  
Classification Of Diseases

Background: The aim of this study was to investigate the association between acute kidney injury (AKI) and in-hospital mortality (IHM) in a large nationwide cohort of elderly subjects in Italy. Methods: We analyzed the hospitalization data of all patients aged ≥65 years, who were discharged with a diagnosis of AKI, which was identified by the presence of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), and extracted from the Italian Health Ministry database (January 2000 to December 2015). Data regarding age, gender, dialysis treatment, and comorbidity, including the development of sepsis, were also collected. Results: We evaluated 760,664 hospitalizations, the mean age was 80.5 ± 7.8 years, males represented 52.2% of the population, and 9% underwent dialysis treatment. IHM was 27.7% (210,661 admissions): Deceased patients were more likely to be older, undergoing dialysis treatment, and to be sicker than the survivors. The population was classified on the basis of tertiles of comorbidity score (the first group 7.48 ± 1.99, the second 13.67 ± 2,04, and third 22.12 ± 4.13). IHM was higher in the third tertile, whilst dialysis-dependent AKI was highest in the first. Dialysis-dependent AKI was associated with an odds ratios (OR) of 2.721; 95% confidence interval (CI) 2.676–2.766; p < 0.001, development of sepsis was associated with an OR of 1.990; 95% CI 1.948–2.033; p < 0.001, the second tertile of comorbidity was associated with an OR of 1.750; 95% CI 1.726–1.774; p < 0.001, and the third tertile of comorbidity was associated with an OR of 2.522; 95% CI 2.486–2.559; p < 0.001. Conclusions: In elderly subjects with AKI discharge codes, IHM is a frequent complication affecting more than a quarter of the investigated population. The increasing burden of comorbidity, dialysis-dependent AKI, and sepsis are the major risk factors.

scholarly journals Update on Changing Terminologies in Sepsis

2016 ◽  
Vol 36 (2) ◽  
pp. 178-183
Author(s):  
Ashish Kumar Simalti ◽  
Ranjit Ghuliani ◽  
Bindu T. Nair
Keyword(s):  
Septic Shock ◽  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Medicine ◽  
European Society ◽  
Task Force ◽  
Critical Care Medicine ◽  
International Consensus ◽  
The Third ◽  
Sepsis And Septic Shock

Definitions of sepsis and septic shock were last revised in 2001. Since then there have been considerable advances in our understanding of pathophysiology, management, and epidemiology of sepsis, suggesting the need for reexamination. The European Society of Intensive Care Medicine and the Society of Critical Care Medicine convened a task force in January 2014 with objective to evaluate and, as needed, update definitions for sepsis and septic shock. Recommendations of this task force were published recently as “The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)”. The aim of this article is to generate awareness and discussion regarding this new important development.  

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