Comparison of modified nutric score, apache li and sofa to predict in-patient mortality in critical ill patient

Introduction Pantoprazole is a proton pump inhibitor (PPI) class drug that is widely used in the treatment of SRMD (stress-related mucosal disease in critical ill patients. PPI are one class of drugs used commonly both for treatment and prophylactic therapy for stress ulcers in intensive care unit (ICU). Case We report a case of a 51-year old male who was referred to PKU Hospital. He was admitted to ICU with diagnosis of Hyperosmolar Hyperglymic State and bronchopneumonia. Thrombocytopenia was noted in admission. There was more than 70% decrease in platelet count after initiation of pantoprazole. Patient received Thrombocyte Concentrate (TC) transfusion and corticosteroid iv for several days, but only had minor increase in platelet count. The platelets recovered after stopping pantoprazole. Discussion In the present case report, another exposures to parenteral pantoprazole in a dose of 40 mg once daily reproduced the same adverse drug reaction. In comparison to lansoprazole, thrombocytopenia from pantoprazole is more severe that necessitate TC transfusion and corticosteroid trial. However, in the present case, TC transfusion and corticosteroid fail to escalate platelet count. This finding suggests probability of non-immune mechanism of pantoprazole-induced thrombocytopenia. Conclusion Pantoprazole may induce thrombocytopenia with new features that were immediately developed, resulting a decrease in platelet count >70%. The mechanism found in this case may be non-immune. Drug-induced thrombocytopenia is one of the rare complications that has to be kept in mind with the use of pantoprazole.

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Association Between Glucocorticoids Treatment and Viral Clearance Delay in Patients with COVID-19: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-138544/v1 ◽

2021 ◽

Author(s):

Jianbo Li ◽

Xuelian Liao ◽

Yue Zhou ◽

Luping Wang ◽

Hang Yang ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Severity Of Illness ◽

Viral Clearance ◽

Cochrane Library ◽

High Dose ◽

Hazard Ratios ◽

Subgroup Analyses ◽

High Doses ◽

Critical Ill

Abstract BackgroundEvidence of glucocorticoids on viral clearance delay of COVID-19 patients is not clear. MethodsIn this systematic review and meta-analysis, we searched studies on Medline, Embase, EBSCO, ScienceDirect, Web of Science, Cochrane Library, and ClinicalTrials.gov from 2002 to December 2, 2020. We mainly pooled the adjusted hazard ratios (HRs), mean difference (MD) or risk ratios (RRs) of viral clearance delay and did subgroup analyses by doses and the severity of illness.ResultsOne trial and 38 observational studies, with a total of 7119 patients, were identified. Glucocorticoids treatment was associated with delayed viral clearance in COVID-19 (Adjusted HR 1.71, 95% CI 1.51 to 1.94, I2=22%, PI 1.45 to 2.01), based on moderate-quality evidence. In subgroup analyses, risk of viral clearance delay was significantly higher among COVID-19 patients being mild or moderate ill (adjusted HR 1.94, 95% CI 1.39 to 2.70, I2=52%; MD 2.59, 95% CI 1.21 to 3.97, I2=24%), but not in those of being severe or critical ill (adjusted HR 1.85, 95% CI 1.05 to 3.26; MD 0.22, 95% CI -1.85 to 2.29, I2=56%); taking high doses (adjusted HR 1.49, 95% CI 1.03 to 2.15; unadjusted RR 1.47, 95% CI 1.12 to 1.94) rather taking low doses (adjusted HR 1.39, 95% CI 0.93 to 2.08; unadjusted RR 1.33, 95% CI 1.00 to 1.77) or pulse (unadjusted RR 1.85, 95% CI 0.66 to 5.19).ConclusionsGlucocorticoids treatment delayed viral clearance in COVID-19 patients of being mild or moderate ill or taking a high dose, rather in those of being severe or critical ill or taking low dose or pulse.

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The Characteristics of Mortality Predictor Scoring for Sepsis Patients in Haji Adam Malik Hospital

International Journal of Research and Review ◽

10.52403/ijrr.20211046 ◽

2021 ◽

Vol 8 (10) ◽

pp. 339-344

Author(s):

Abdul Halim Harahap ◽

Franciscus Ginting ◽

Lenni Evalena Sihotang

Keyword(s):

Sofa Score ◽

Scoring System ◽

Scoring Systems ◽

Developed Countries ◽

Apache Ii ◽

Apache Ii Score ◽

P Value ◽

Cross Sectional ◽

Cross Sectional Design ◽

Score Apache

Introduction: Sepsis is a leading cause of death in the Intensive Care Unit (ICU) in developed countries and its incidence is increasing. Many scoring systems are used to assess the severity of disease in patients admitted to the ICU. SOFA score to assess the degree of organ dysfunction in septic patients. The Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system is most often used for patients admitted to the ICU. CCI scoring system to assess the effect of comorbid disease in critically ill patients on mortality. The study aimed to describe the characteristics of the use of scoring to predict patients’ mortality admitted to Haji Adam Malik Hospital. Methods: This is an observational study with a cross-sectional design. A total of 299 study subjects met the inclusion criteria and exclusion criteria, three types of scoring, namely SOFA score, APACHE II score, and CCI score were used to assess the prognosis of septic patients. Data analysis was performed using SPSS. P-value <0.05 was considered statistically significant. Results: A total of 252 people (84.3%) of sepsis patients died. The mean age of the septic patients who died was 54.25 years. The SOFA score ranged from 0-24, the median SOFA score in deceased sepsis patients was 5.0. The APACHE II score ranged from 0-71, the median APACHE II score in deceased sepsis patients was 23.0. The CCI score ranged from 0-37, the median CCI score in deceased sepsis patients was 5.0. Conclusion: Higher scores are associated with an increased probability of death in septic patients. Keywords: Sepsis; mortality predictor; SOFA score; APACHE II score, CCI score.

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Ionized or Total Magnesium levels, what should we measure in critical ill patients?

Translational Medicine @ UniSa ◽

10.37825/2239-9747.1015 ◽

2021 ◽

Vol 23 (4) ◽

Author(s):

Giuliana Scarpati ◽

Daniela Baldassarre ◽

Filomena Oliva ◽

Gabriele Pascale ◽

Ornella Piazza

Keyword(s):

Critical Ill Patients ◽

Total Magnesium ◽

Critical Ill

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Association Between Glucocorticoids Treatment and Viral Clearance Delay in Patients with COVID-19: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-138544/v2 ◽

2021 ◽

Author(s):

Jianbo Li ◽

Xuelian Liao ◽

Yue Zhou ◽

Luping Wang ◽

Hang Yang ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Severity Of Illness ◽

Viral Clearance ◽

Cochrane Library ◽

High Dose ◽

Hazard Ratios ◽

Subgroup Analyses ◽

High Doses ◽

Critical Ill

Abstract Background Evidence of glucocorticoids on viral clearance delay of COVID-19 patients is not clear. Methods In this systematic review and meta-analysis, we searched studies on Medline, Embase, EBSCO, ScienceDirect, Web of Science, Cochrane Library, and ClinicalTrials.gov from 2002 to December 2, 2020. We mainly pooled the adjusted hazard ratios (HRs), mean difference (MD) or risk ratios (RRs) of viral clearance delay and did subgroup analyses by doses and the severity of illness.Results One trial and 38 observational studies, with a total of 7119 patients, were identified. Glucocorticoids treatment was associated with delayed viral clearance in COVID-19 (Adjusted HR 1.71, 95% CI 1.51 to 1.94, I2=22%, PI 1.45 to 2.01), based on moderate-quality evidence. In subgroup analyses, risk of viral clearance delay was significantly higher among COVID-19 patients being mild or moderate ill (adjusted HR 1.94, 95% CI 1.39 to 2.70, I2=52%; MD 2.59, 95% CI 1.21 to 3.97, I2=24%), but not in those of being severe or critical ill (adjusted HR 1.85, 95% CI 1.05 to 3.26; MD 0.22, 95% CI -1.85 to 2.29, I2=56%); taking high doses (adjusted HR 1.49, 95% CI 1.03 to 2.15; unadjusted RR 1.47, 95% CI 1.12 to 1.94) rather taking low doses (adjusted HR 1.39, 95% CI 0.93 to 2.08; unadjusted RR 1.33, 95% CI 1.00 to 1.77) or pulse (unadjusted RR 1.85, 95% CI 0.66 to 5.19).Conclusions Glucocorticoids treatment delayed viral clearance in COVID-19 patients of being mild or moderate ill or taking a high dose, rather in those of being severe or critical ill or taking low dose or pulse.

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