Predictors of mortality of bloodstream infections among internal medicine patients in a Swiss Hospital: Role of quick Sequential Organ Failure Assessment

2019 ◽  
Vol 65 ◽  
pp. 86-92 ◽  
Author(s):  
Matthaios Papadimitriou-Olivgeris ◽  
Roxanni Psychogiou ◽  
Jonathan Garessus ◽  
Adeline De Camaret ◽  
Nicolas Fourre ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Bloodstream Infections ◽  
Predictors Of Mortality ◽  
Failure Assessment

Predictors of mortality of influenza virus infections in a Swiss Hospital during four influenza seasons: Role of quick sequential organ failure assessment

2020 ◽  
Vol 74 ◽  
pp. 86-91 ◽  
Author(s):  
Matthaios Papadimitriou-Olivgeris ◽  
Nikitas Gkikopoulos ◽  
Melissa Wüst ◽  
Aurelie Ballif ◽  
Valentin Simonin ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Virus Infections ◽  
Predictors Of Mortality ◽  
Failure Assessment

Risk assessment of the blunt trauma victim: The role of the quick Sequential Organ Failure Assessment Score (qSOFA)

2017 ◽  
Vol 214 (3) ◽  
pp. 397-401 ◽  
Author(s):  
Randeep S. Jawa ◽  
James A. Vosswinkel ◽  
Jane E. McCormack ◽  
Emily C. Huang ◽  
Henry C. Thode ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Blunt Trauma ◽  
Trauma Victim ◽  
Assessment Score ◽  
Failure Assessment

scholarly journals Ultrasonic Assessment of Optic Nerve Sheath Diameter in Patients at Risk of Sepsis-Associated Brain Dysfunction: A Preliminary Report

2020 ◽  
Vol 17 (10) ◽  
pp. 3656 ◽  
Author(s):  
Piotr F. Czempik ◽  
Jakub Gąsiorek ◽  
Aleksandra Bąk ◽  
Łukasz J. Krzych
Keyword(s):  
Optic Nerve ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Optic Nerve Sheath Diameter ◽  
Brain Dysfunction ◽  
Optic Nerve Sheath ◽  
Non Invasive ◽  
Nerve Sheath ◽  
Failure Assessment

Sepsis-associated brain dysfunction (SABD) with increased intracranial pressure (ICP) is a complex pathology that can lead to unfavorable outcome. Ultrasonographic measurement of optic nerve sheath diameter (ONSD) is used for non-invasive assessment of ICP. We aimed to assess the role of ONSD as a SABD screening tool. This prospective preliminary study covered 10 septic shock patients (5 men; aged 65, IQR 50–78 years). ONSD was measured bilaterally from day 1 to 10 (n = 1), until discharge (n = 3) or death (n = 6). The upper limit for ONSD was set at 5.7 mm. Sequential organ failure assessment score was calculated on a daily basis as a surrogate formulti-organ failure due to sepsis in the study population. On day 1, the medians of right and left ONSD were 5.56 (IQR 5.35–6.30) mm and 5.68 (IQR 5.50–6.10) mm, respectively, and four subjects had bilaterally elevated ONSD. Forty-nine out of 80 total measurements performed (61%) exceeded 5.7 mm during the study period. We found no correlations between ONSD and sequential organ failure assessment (SOFA) during the study period (right: R = −0.13–0.63; left R = −0.24–0.63). ONSD measurement should be applied for screening of SABD cautiously. Further research is needed to investigate the exact role of this non-invasive method in the assessment of brain dysfunction in these patients.

The role of syndecan-1 for DIC diagnosis in hemoblastosis patients with sepsis.

2021 ◽  
Author(s):  
А.В. Лянгузов ◽  
О.Ю. Сергунина ◽  
С.В. Игнатьев ◽  
Е.Л. Назарова ◽  
С.Л. Калинина ◽  
...  
Keyword(s):  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Systemic Inflammation ◽  
International Society ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Biochemical Data ◽  
Healthy Donors ◽  
Failure Assessment

Введение. Синдром диссеминированного внутрисосудистого свертывания (ДВС-синдром) является частым осложнением онкогематологических заболеваний. Известно, что повреждение эндотелия сосудов играет одну из ключевых ролей в развитии коагулопатии потребления, особенно в условиях системного воспаления. Повышение концентрации синдекана-1, одного из основных протеогликанов эндотелиального гликокаликса, в плазме крови описано при различных патологических состояниях, включая острые лейкозы и ДВС-синдром. Определение его содержания у больных гемобластозами может способствовать ранней диагностике ДВС-синдрома и своевременному назначению патогенетической терапии. Цель исследования: оценить роль протеогликана синдекан-1 в диагностике ДВС-синдрома у больных гемобластозами с сепсисом. Материалы и методы. Проведен анализ гематологических и биохимических показателей периферической крови, коагулограммы, кислотно-основного состояния и сывороточного содержания синдекана-1 у 54 больных гемобластозами с признаками системного воспаления. Острый миелоидный лейкоз диагностирован у 19 (35%), острый лимфобластный лейкоз – у 10 (18%), неходжкинская лимфома – у 13 (24%), лимфома Ходжкина – у 9 (17%), множественная миелома – у 3 (6%). Концентрацию синдекана-1 сравнивали с таковой у здоровых доноров. Наличие ДВС-синдрома определяли по шкале DIC-score Международного общества по тромбозам и гемостазу (англ. International Society on Thrombosis and Hemostasis, ISTH), степень органных дисфункций – по шкале SOFA (англ. Sequential Organ Failure Assessment). Сепсис верифицировали по критериям консенсуса «Сепсис-3». Взаимосвязь уровня синдекана-1 с показателями гемограммы, коагулограммы, биохимическими параметрами и данными шкал DIC и SOFA оценивали с использованием критерия Спирмена. Диагностическую роль синдекана-1 определяли при помощи ROC-анализа. Результаты. У больных гемобластозами выявлено повышение уровня синдекана-1 по сравнению с таковым у здоровых доноров в 5,8 раз (р = 0,008). Сепсис диагностирован у 28 (52%) пациентов, явный ДВС-синдром выявлен у 14 (25%). Концентрация синдекана-1 в сыворотке крови коррелировала со значениями активированного парциального тромбопластинового времени и протромбинового времени, количеством тромбоцитов, активностью антитромбина III, показателями шкал DIC-score и SOFA. Определена диагностическая роль синдекана-1 при развитии явного ДВС-синдрома (точка отсечения – 5,48 нг/мл, чувствительность – 73%, специфичность – 90%). Заключение. Повышенный уровень синдекана-1 (более 5,48 нг/мл) может служить дополнительным критерием развития ДВС-синдрома у больных гемобластозами с сепсисом. Background. Disseminated intravascular coagulation (DIC) is a severe complication of hemoblastosis. The key role of the vascular endothelium in hemostasis regulation is well known. Its activation and damage are the most important factors of consumption coagulopathy during systemic inflammation. Increased blood level of one of the main proteoglycans of the endothelial glycocalyx – syndecan-1 has been described in various pathological conditions, including acute leukemia and DIC. Syndecan-1 level evaluation in patients with hemoblastosis can help early DIC diagnosis and improve therapy results. Objectives: to assess the role of syndecan-1 for DIC diagnosis in hemablastosis patients with sepsis. Patients/Methods. Hematological and biochemical data of peripheral blood, coagulogram, acid-base balance and serum level of syndecan-1 were analyzed in 54 patients with hemoblastosis with signs of systemic inflammation. Acute myeloid leukemia was diagnosed in 19 (35%) patients, acute lymphoblastic leukemia – in 10 (18%), non-Hodgkin’s lymphoma – in 13 (24%), Hodgkin’s lymphoma – in 9 (17%), multiple myeloma – in 3 (6%). Syndecan-1 concentration was compared with that of healthy donors. DIC was assessed by DIC-score (ISTH, International Society on Thrombosis and Hemostasis), organ dysfunction – by SOFA (Sequential Organ Failure Assessment) score. Sepsis was verified according to the third international consensus definitions for sepsis and septic shock. Relationship of syndecan-1 level with hematological, сoagulological, biochemical data and DIC or SOFA scores was assessed by Spearman rank correlation. The diagnostic value of syndecan-1 was determined by ROC-analysis. Results. Increased level of syndecan-1 in 5.8 times was revealed in patients with hemoblastosis in comparison to healthy donors (p = 0.008). Sepsis was diagnosed in 28 (52%) patients, overt DIC – in 14 (25%). Serum syndecan-1 level correlated with activated partial thromboplastin time, prothrombin time, platelet count, antithrombin III activity, DIC and SOFA scores. The diagnostic role of syndecan-1 was determined in overt DIC (cut-off – 5.48 ng/ml, sensitivity – 73%, specificity – 90%). Conclusions. Increased syndecan-1 level (more than 5.48 ng/ml) can be additional diagnostic criterion for DIC in patients with hematological malignancies and sepsis.

scholarly journals Role of qSOFA and SOFA Scoring Systems for Predicting In-Hospital Risk of Deterioration in the Emergency Department

2020 ◽  
Vol 17 (22) ◽  
pp. 8367
Author(s):  
Raúl López-Izquierdo ◽  
Pablo del Brio-Ibañez ◽  
Francisco Martín-Rodríguez ◽  
Alicia Mohedano-Moriano ◽  
Begoña Polonio-López ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Initial Assessment ◽  
Failure Assessment ◽  
Risk Patients ◽  
Qsofa Score

The objective of this study was to analyze and compare the usefulness of quick sequential organ failure assessment score (qSOFA) and sequential organ failure assessment (SOFA) scores for the detection of early (two-day) mortality in patients transported by emergency medical services (EMSs) to the emergency department (ED) (infectious and non-infectious). We performed a multicentric, prospective and blinded end-point study in adults transported with high priority by ambulance from the scene to the ED with the participation of five hospitals. For each score, the area under the curve (AUC) of the receiver operating characteristic (ROC) curve was calculated. We included 870 patients in the final cohort. The median age was 70 years (IQR 54–81 years), and 338 (38.8%) of the participants were women. Two-day mortality was 8.3% (73 cases), and 20.9% of cases were of an infectious pathology. For two-day mortality, the qSOFA presented an AUC of 0.812 (95% CI: 0.75–0.87; p < 0.001) globally with a sensitivity of 84.9 (95% CI: 75.0–91.4) and a specificity of 69.4 (95% CI: 66.1–72.5), and a SOFA of 0.909 (95% CI: 0.86–0.95; p < 0.001) with sensitivity of 87.7 (95% CI: 78.2–93.4) and specificity of 80.7 (95% CI: 77.4–83.3). The qSOFA score can serve as a simple initial assessment to detect high-risk patients, and the SOFA score can be used as an advanced tool to confirm organ dysfunction.

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