scholarly journals Protein carbonyl concentration as a biomarker for development and mortality in sepsis-induced acute kidney injury

2018 ◽  
Vol 38 (1) ◽  
Author(s):  
Nara Aline Costa ◽  
Ana Lúcia Gut ◽  
Paula Schmidt Azevedo ◽  
Suzana Erico Tanni ◽  
Natália Baraldi Cunha ◽  
...  
Keyword(s):  
Septic Shock ◽  
Prospective Observational Study ◽  
Kidney Injury ◽  
Protein Carbonyl ◽  
Apache Ii Score ◽  
Roc Curve Analysis ◽  
Logistic Regression Models ◽  
Icu Admission ◽  
Icu Stay ◽  
The Mean

The objective of the present study was to evaluate protein carbonyl concentration as a predictor of AKI development in patients with septic shock and of renal replacement therapy (RRT) and mortality in patients with SAKI. This was a prospective observational study of 175 consecutive patients over the age of 18 years with septic shock upon Intensive Care Unit (ICU) admission. After exclusion of 46 patients (27 due to AKI at ICU admission), a total of 129 patients were enrolled in the study. Demographic information and blood samples were taken within the first 24 h of the patient’s admission to determine serum protein carbonyl concentrations. Among the patients who developed SAKI, the development of AKI was evaluated, along with mortality and need for RRT. The mean age of the patients was 63.3 ± 15.7 years, 47% were male and 51.2% developed SAKI during ICU stay. In addition, protein carbonyl concentration was shown to be associated with SAKI. Among 66 patients with SAKI, 77% died during the ICU stay. Protein carbonyl concentration was not associated with RRT in patients with SAKI. However, the ROC curve analysis revealed that higher levels of protein carbonyl were associated with mortality in these patients. In logistic regression models, protein carbonyl level was associated with SAKI development (OR: 1.416; 95% CI: 1.247–1.609; P<0.001) and mortality when adjusted by age, gender, and APACHE II score (OR: 1.357; 95% CI: 1.147–1.605; P<0.001). In conclusion, protein carbonyl concentration is predictive of AKI development and mortality in patients with SAKI, with excellent reliability.

Protein Carbonyl, But Not Malondialdehyde, Is Associated With ICU Mortality in Patients With Septic Shock

2017 ◽  
Vol 34 (8) ◽  
pp. 669-673 ◽  
Author(s):  
Nara Aline Costa ◽  
Ana Lucia Gut ◽  
Paula Schmidt Azevedo ◽  
Ana Angelica Henrique Fernandes ◽  
Bertha Furlan Polegato ◽  
...  
Keyword(s):  
Septic Shock ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Protein Carbonyl ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Icu Mortality ◽  
Logistic Regression Models ◽  
The Mean

Background:The objective of our study was to evaluate the association of serum malondialdehyde (MDA) and protein carbonyl concentration with intensive care unit (ICU) mortality in patients with septic shock.Methods:We prospectively evaluated 175 patients aged over 18 years with septic shock upon ICU admission. However, 16 patients were excluded. Thus, 159 patients were enrolled in the study. In addition, we evaluated 16 control patients. At the time of the patients’ enrollment, demographic information was recorded. Blood samples were taken within the first 24 hours of the patient’s admission to determine serum MDA and protein carbonyl concentrations.Results:The mean age was 67.3 ± 15.9 years, 44% were males, and the ICU mortality rate was 67.9%. Median MDA concentration was 1.53 (0.83-2.22) µmol/L, and median protein carbonyl concentration was 24.0 (12.7-32.8) nmol/mL. Patients who died during ICU stay had higher protein carbonyl concentration. However, there was no difference in MDA levels between these patients. Receiver operating characteristic curve analysis showed that higher levels of protein carbonyl were associated with ICU mortality (area under the curve: 0.955; 95% confidence interval [CI]: 0.918-0.992; P < .001) at the cutoff of >22.83 nmol/mL (sensibility: 80.4% and specificity: 98.1%). In the logistic regression models, protein carbonyl concentrations (odds ratio [OR]: 1.424; 95% CI: 1.268-1.600; P < .001), but not MDA concentrations (OR: 1.087; 95% CI: 0.805-1.467; P = .59), were associated with ICU mortality when adjusted for age, gender, and Acute Physiology and Chronic Health Evaluation (APACHE) II score; and when adjusted by APACHE II score, lactate, and urea; protein carbonyl concentrations (OR: 1.394; 95% CI: 1.242-1.564; P < .001); and MDA (OR: 1.054; 95% CI: 0.776-1.432; P = .73).Conclusion:In conclusion, protein carbonyl, but not MDA, concentration is associated with ICU mortality in patients with septic shock.

scholarly journals Ultrasound for Non-invasive Assessment and Monitoring of Quadriceps Muscle Thickness in Critically Ill Patients With Acute Kidney Injury

2021 ◽  
Vol 8 ◽  
Author(s):  
Alice Sabatino ◽  
Umberto Maggiore ◽  
Giuseppe Regolisti ◽  
Giovanni Maria Rossi ◽  
Francesca Di Mario ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Muscle Wasting ◽  
Kidney Injury ◽  
Muscle Thickness ◽  
Quadriceps Muscle ◽  
Apache Ii Score ◽  
Icu Admission ◽  
Icu Stay

Background and aims: Critically ill patients with acute kidney injury (AKI) undergo major muscle wasting in the first few days of ICU stay. An important concern in this clinical setting is the lack of adequate tools for routine bedside evaluation of the skeletal muscle mass, both for the determination of nutritional status at admission, and for monitoring. In this regard, the present study aims to ascertain if ultrasound (US) is able to detect changes in quadriceps muscle thickness of critically ill patients with acute kidney injury (AKI) over short periods of time.Methods: This is a prospective observational study with a follow-up at 5 days. All adult patients with AKI hospitalized at the Renal ICU of the Parma University Hospital over 12 months, with a hospital stay before ICU admission no longer than 72 h, and with a planned ICU stay of at least 5 days, were eligible for the study. An experienced investigator assessed quadriceps rectus femoris and vastus intermedius thickness (QRFT and QVIT) at baseline and after 5 days of ICU stay.Results: We enrolled 30 patients with 74 ± 11 years of age and APACHE II score of 22 ± 5. Muscle thickness decreased by 15 ± 13% within the first 5 days of ICU stay (P &lt; 0.001 for all sites as compared to ICU admission). Patients with more severe muscle loss had lower probability of being discharged home (OR: 0.04, 95%CI: 0.00–0.74; P = 0.031).Conclusions: In critically ill patients with AKI, bedside muscle US identifies patients with accelerated muscle wasting.

scholarly journals SARS-CoV-2 Renal Impairment in Critical Care: An Observational Study of 42 Cases (Kidney COVID)

2021 ◽  
Vol 10 (8) ◽  
pp. 1571
Author(s):  
Antoine-Marie Molina Barragan ◽  
Emmanuel Pardo ◽  
Pierre Galichon ◽  
Nicolas Hantala ◽  
Anne-Charlotte Gianinazzi ◽  
...  
Keyword(s):  
Renal Impairment ◽  
Renal Injury ◽  
Kidney Injury ◽  
Critical Factor ◽  
University Hospital ◽  
Co2 Partial Pressure ◽  
Icu Admission ◽  
Icu Stay ◽  
Arterial Blood ◽  
Mixed Pattern

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leads to 5% to 16% hospitalization in intensive care units (ICU) and is associated with 23% to 75% of kidney impairments, including acute kidney injury (AKI). The current work aims to precisely characterize the renal impairment associated to SARS-CoV-2 in ICU patients. Forty-two patients consecutively admitted to the ICU of a French university hospital who tested positive for SARS-CoV-2 between 25 March 2020, and 29 April 2020, were included and classified in categories according to their renal function. Complete renal profiles and evolution during ICU stay were fully characterized in 34 patients. Univariate analyses were performed to determine risk factors associated with AKI. In a second step, we conducted a logistic regression model with inverse probability of treatment weighting (IPTW) analyses to assess major comorbidities as predictors of AKI. Thirty-two patients (94.1%) met diagnostic criteria for intrinsic renal injury with a mixed pattern of tubular and glomerular injuries within the first week of ICU admission, which lasted upon discharge. During their ICU stay, 24 patients (57.1%) presented AKI which was associated with increased mortality (p = 0.007), hemodynamic failure (p = 0.022), and more altered clearance at hospital discharge (p = 0.001). AKI occurrence was associated with lower pH (p = 0.024), higher PaCO2 (CO2 partial pressure in the arterial blood) (p = 0.027), PEEP (positive end-expiratory pressure) (p = 0.027), procalcitonin (p = 0.015), and CRP (C-reactive protein) (p = 0.045) on ICU admission. AKI was found to be independently associated with chronic kidney disease (adjusted OR (odd ratio) 5.97 (2.1–19.69), p = 0.00149). Critical SARS-CoV-2 infection is associated with persistent intrinsic renal injury and AKI, which is a risk factor of mortality. Mechanical ventilation settings seem to be a critical factor of kidney impairment.

Predicting value of prehospital body temperature for ICU admission of septic shock patients

2019 ◽  
Vol 18 (1) ◽  
pp. 56-58
Author(s):  
Romain Jouffroy ◽  
◽  
Anastasia Saade ◽  
Stephane Durand ◽  
Pascal Philippe ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Body Temperature ◽  
Propensity Score Analysis ◽  
Call Centre ◽  
Icu Patients ◽  
Icu Admission ◽  
Score Analysis ◽  
The Mean ◽  
Proper Orientation

To specify whether an association exists between pre-hospital body temperature collected by the emergency medical services (EMS) call centre, and intensive care unit (ICU) admission of patients with septic shock. An observational study based on data collected by the EMS of Paris. All septic shocks were included. Among, the 140 calls concerning septic shock, 22 patients (16%) were admitted to ICU. The mean core temperature was 37.4±1.6°C for ICU and 38.6±1.1°C (p<4.10^-5) for non-ICU patients. Using propensity score analysis, the relative risk for ICU admission of patients with pre-hospital fever or hypothermia was 0.31 and 2 respectively. The study highlights the potential usefulness of early temperature measurement in septic shock patients to allow early proper orientation.

scholarly journals Diagnostic and Prognostic Value of Presepsin in Patients with Non-Infectious Organ Failure, Sepsis, and Septic Shock: A Prospective Observational Study According to the Sepsis-3 Definitions

2021 ◽  
Author(s):  
Sukyo Lee ◽  
Juhyun Song ◽  
Dae Won Park ◽  
Hyeri Seok ◽  
Jae-hyung Cha ◽  
...  
Keyword(s):  
Septic Shock ◽  
Observational Study ◽  
Organ Failure ◽  
Prospective Observational Study ◽  
Survival Curve ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Kaplan Meier ◽  
Sepsis And Septic Shock ◽  
Meier Survival Curve

Abstract Background: Sepsis is life-threatening organ dysfunction due to a dysregulated host response to infection. Early diagnosis of sepsis is challenging due to unknown sources of infection, and mortality prediction is usually complex. We aimed to investigate the clinical value of presepsin for discriminating sepsis from non-infectious organ failure and predicting mortality among sepsis patients in the emergency department (ED).Methods: This prospective observational study included 420 patients divided into three groups according to the Sepsis-3 definitions: non-infectious organ failure (n=142), sepsis (n=141), and septic shock (n=137). Blood samples for biomarker measurement of presepsin, procalcitonin, and C-reactive protein were drawn in the ED and biomarker levels were compared between the groups. Optimal cut-off values for presepsin to discriminate between the three clinical diagnoses were evaluated using receiver operating characteristic (ROC) curve analysis. We also performed ROC curve analysis for each biomarker as a predictor of mortality. After excluding non-infectious organ failure, we extracted the optimal cut-off value of presepsin to predict mortality associated with sepsis and septic shock and performed Kaplan–Meier survival curve analysis according to the cut-off value.Results: Presepsin levels (median [IQR]) were significantly higher in sepsis than in non-infectious organ failure (792 [450–1273] vs. 286 [170–417], p <0.001) and significantly higher in septic shock than in sepsis (1287 [589–2365] vs. 792 [450–1273], p=0.002). The optimal cut-off value for presepsin to discriminate between sepsis and non-infectious organ failure was 582 pg/mL (sensitivity, 70.1; specificity, 89.4; AUC, 0.877; p <0.001) and to discriminate between sepsis and septic shock was 1285 pg/mL (sensitivity, 50.4; specificity, 76.6; AUC, 0.618; p <0.001). The optimal cut-off value for presepsin for predicting 30-day mortality was 821 pg/mL (sensitivity, 68.9; specificity, 50.5; AUC, 0.605; p=0.005) in patients with sepsis and septic shock. Kaplan-Meier survival curve analysis showed that patients with higher presepsin levels (≥821 pg/mL) had significantly higher mortality than patients with lower presepsin levels (<821 pg/mL) (log-rank test; p=0.004). Conclusions: Presepsin levels could effectively differentiate sepsis from non-infectious organ failure and septic shock from sepsis. Presepsin levels could help clinicians predict mortality in patients with sepsis and septic shock.

scholarly journals Evaluation of peptidylarginine deiminase 4 concentration and PADI4 polymorphisms in sepsis-induced acute kidney injury

2019 ◽  
Author(s):  
Nara Aline Costa ◽  
Bertha Furlan Polegato ◽  
Amanda Gomes Pereira ◽  
Rodrigo Velloni da Silva Bastos ◽  
Sérgio Alberto Rupp de Paiva ◽  
...  
Keyword(s):  
Septic Shock ◽  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Kidney Injury ◽  
Peptidylarginine Deiminase ◽  
Plasma Urea ◽  
Blood Samples ◽  
Icu Stay ◽  
Plasma Urea Concentration ◽  
Its Polymorphism

Abstract Background: The influence of PAD4 concentration and its polymorphisms in SAKI development are poorly evaluated. Thus, the aim of this study is to evaluate the PAD 4 concentration and PADI4 polymorphisms, as predictors of AKI development, need for renal replacement therapy (RRT), and mortality in patients with septic shock. Methods: We included all individuals aged ≥ 18 years, with the diagnosis of septic shock at ICU admission. Blood samples were taken within the first 24 hours of the patient’s admission to determine serum PAD4 concentration and its polymorphism PADI4 (rs11203367) and (rs874881). Patients were followed during their ICU stay and the development of SAKI was evaluated. Among the patients in whom SAKI developed, mortality and need for RRT were also evaluated. Results: 99 patients were included in the analysis. SAKI developed in approximately 51.5% of patients during the ICU stay; of these, 21.5% required RRT and 80% died. There was no difference between PAD4 concentration (p = 0.116) and its polymorphisms rs11203367 (p = 0.910) and rs874881 (p = 0.769) in patients in whom SAKI did or did not develop. However, PAD4 had a positive correlation with plasma urea concentration (r = 0.269 and p = 0.007) and creatinine (r = 0.284 and p = 0.004). The PAD4 concentration and PADI4 polymorphisms were also not associated with RRT and with mortality in patients with SAKI. Conclusion: PAD4 concentration and its polymorphisms were not associated with SAKI development, the need for RRT, or mortality in patients with septic shock. However, PAD4 concentrations were associated with creatinine and urea levels in these patients.

Abstract 17113: Secondary Infections Are Common in Patients Hospitalized for COVID-19 and Are Associated With Severe Outcomes

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Elizabeth R Anderson ◽  
Tariq Azam ◽  
Husam Shadid ◽  
Michael Pan ◽  
Hanna Berlin ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Viral Infections ◽  
Clinical Laboratory ◽  
Secondary Infection ◽  
Kidney Injury ◽  
Outcome Data ◽  
Hospitalized Patients ◽  
Secondary Infections ◽  
Life Threatening ◽  
The Mean

Background: Secondary infections occur in 10-15% of critically ill sepsis patients. Anecdotal reports suggest secondary infections are common in coronavirus disease 2019 (COVID-19), however data are lacking. We examine the rate of secondary infections in hospitalized patients with COVID-19 and its impact on the cytokine surge and in-hospital outcomes. Methods: The Michigan Medicine Covid-19 Cohort (M2C2) is an ongoing prospective observational study in which detailed clinical, laboratory and outcome data were collected from chart review of consecutive adult patients hospitalized for COVID-19. Patients who were positive for SARS-CoV-2 infection but without respiratory symptoms were not included in this cohort. We define secondary infections as physician-diagnosed and treated bacterial or viral infections secondary to SARS-CoV-2. Results: Of 553 COVID-19 patients hospitalized at Michigan Medicine, 191 (34.5%) developed a secondary infection during hospitalization. The mean age of patients with a secondary infection was 60 years, 61.3% were male compared to 58.8 years, 53.5% male in patients with no secondary infection. Bacterial pneumonia, including ventilator-associated pneumonia, was the most prevalent secondary infection among hospitalized patients (78.5%). Other secondary infections included urosepsis (14.1%), bacteremia (16.8%), and 17.3% of patients developed other types of infections such as shingles and clostridium difficile. 25.8% of patients without secondary infections received antibiotics during their admission compared to 47.1% of patients with secondary infections. Multiple secondary infections (>1) occurred in 43 (8.2%) of patients. Patients with secondary infections were more likely to develop acute kidney injury (78.0% vs. 38.3%, p<0.0001), acute respiratory distress syndrome (78.0% vs. 22.3%, p<0.0001), and death (26.2% vs. 10.2%, p<0.0001) during their hospitalization compared to patients without secondary infections. Conclusions: Secondary infections are common in hospitalized patients with COVID-19 and are associated with life-threatening complications and high mortality. This study suggests that secondary infection prevention may be especially important in COVID-19 patients.

scholarly journals Urinary TIMP2 and IGFBP7 Identifies High Risk Patients of Short-Term Progression from Mild and Moderate to Severe Acute Kidney Injury during Septic Shock: A Prospective Cohort Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Julien Maizel ◽  
Delphine Daubin ◽  
Ly Van Vong ◽  
Dimitri Titeca-Beauport ◽  
Morgane Wetzstein ◽  
...  
Keyword(s):  
Septic Shock ◽  
High Risk ◽  
Early Phase ◽  
Urine Output ◽  
Univariate Analysis ◽  
Kidney Injury ◽  
Urinary Biomarkers ◽  
Baseline Serum ◽  
Multicenter Observational Study ◽  
Logistic Regression Models

Background. To examine whether the new urinary biomarkers TIMP2 and IGFBP7 can predict progression within 24 hours and 72 hours from mild and moderate (KDIGO 1 or 2) to severe (KDIGO 3) AKI in patients with septic shock. Methods. A prospective, multicenter observational study performed in three French ICUs. The urinary biomarkers TIMP2∗IGFBP7 were analyzed at the early phase (<6 hours) of patients admitted for septic shock with mild and moderate AKI. Results. Among the 112 patients included, 45 (40%) progressed to the KDIGO 3 level 24 hours after inclusion (KDIGO 3 H24) and 47 (42%) 72 hours after inclusion (KDIGO 3 H72). The median urinary TIMP2∗IGFBP7 at inclusion (baseline) were higher in the KDIGO 3 group than in the KDIGO<3 group at H24 and H72. All covariates with a p value < 0.1 in the univariate analysis were included in stepwise multiple logistic regression models to identify factors independently associated with the risk of KDIGO 3 at H24 and H72. TIMP2∗IGFBP7 remained independently associated with KDIGO 3 at H24 and H72. Baseline posology of norepinephrine, baseline urine output, and baseline serum creatinine remained also significantly associated with progression to KDIGO 3 at H24. Baseline TIMP2∗IGFBP7 and baseline urinary output had the best AUC ROC. A baseline TIMP2∗IGFBP7>2.0 (ng/ml)2/1,000 identified the population at high risk of KDIGO 3 H24 (relative risk 4.19 (1.7-10.4)) with a sensitivity of 76% (60-87) and a specificity of 81% (69-89). But the diagnostic performance at H72 of baseline TIMP2∗IGFBP7 was poor (AUC: 0.69 (0.59-0.77)). Conclusion. The urinary TIMP2∗IGFBP7 concentration and the urine output at the early phase of septic shock are independent factors to identify the population at high risk of progression from mild and moderate to severe AKI over the next 24 but not 72 hours. A TIMP2∗IGFBP7 concentration>2.0 (ng/ml)2/1,000 quadruples the risk of KDIGO 3 AKI within 24 hours. This trial is registered with (NCT03547414).

scholarly journals Correlation of plasma fibrinogen and mean platelet volume in patients of sepsis to the severity of sepsis and its outcome

2020 ◽  
Vol 7 (12) ◽  
pp. 1830
Author(s):  
Ketan Chalodiya ◽  
Arun Bahulikar ◽  
Vrushali Khadke ◽  
Deepak Phalgune
Keyword(s):  
Septic Shock ◽  
Mean Platelet Volume ◽  
Fibrinogen Level ◽  
Prognostic Indicator ◽  
Plasma Fibrinogen ◽  
Apache Ii Score ◽  
Continuous Variables ◽  
Platelet Volume ◽  
Exact Test ◽  
The Mean

Background: The prognostic value of mean platelet volume (MPV) and plasma fibrinogen level in terms of survival in patients with sepsis and septic shock is still incompletely documented. The aim of the present study was to find a correlation between MPV and plasma fibrinogen with the severity of sepsis and mortality.Methods: Three hundred eleven patients having quick sequential organ failure assessment score 2/3, systolic blood pressure ≤100 mmHg, respiratory rate ≥22/minute and altered mentation <15 (Glasgow coma scale) were included for this prospective observational study. Acute physiology and chronic health evaluation (APACHE) II score, MPV on days one and four, fibrinogen on days one and seven were tested. The number of days of intensive care unit (ICU), and hospital stay, in-hospital mortality was recorded. Categorical and continuous variables were tested using the chi-square test/Fisher’s exact test and analysis of variance/Kruskal-Wallis H test respectively.Results: The mean plasma fibrinogen at day one and day seven was significantly higher in patients who had septic shock and in expired patients. The mean MPV at day four was significantly higher in patients who expired compared to those who survived. The mean MPV on day four was significantly higher compared to the mean MPV at day one in patients who expired.Conclusions: Fibrinogen level at admission is the predictor of mortality in patients with sepsis or septic shock. An increase in MPV was strongly correlated with mortality and can be used as a prognostic indicator.

scholarly journals Risk of invasive candidiasis with prolonged duration of ICU stay: a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036452
Author(s):  
Zhidan Zhang ◽  
Ran Zhu ◽  
Zhenggang Luan ◽  
Xiaochun Ma
Keyword(s):  
Hospital Stay ◽  
Meta Analysis ◽  
Icu Admission ◽  
Duration Of Hospital Stay ◽  
Icu Stay ◽  
Significant Difference ◽  
The Mean ◽  
Meta Regression ◽  
Length Of Icu Stay ◽  
Overall Mortality

ObjectiveThis study aimed to evaluate the duration of intensive care unit (ICU) stay prior to onset of invasive candidiasis (IC)/candidaemia.DesignSystematic review and meta-analysis.Data sourcesPubMed, Cochrane, Embase and Web of Science databases were searched through June 2019 to identify relevant studies.Eligibility criteriaAdult patients who had been admitted to the ICU and developed an IC infection.Data extraction and synthesisThe following data were extracted from each article: length of hospital stay, length of ICU stay, duration of ICU admission prior to candidaemia onset, percentage of patients who received antibiotics and duration of their antibiotic therapy prior to candidaemia onset, and overall mortality. In addition to the traditional meta-analyses, meta-regression was performed to explore possible mediators which might have contributed to the heterogeneity.ResultsThe mean age of patients ranged from 28 to 76 years across selected studies. The pooled mean duration of ICU admission before onset of candidaemia was 12.9 days (95% CI 11.7 to 14.2). The pooled mean duration of hospital stay was 36.3±5.3 days (95% CI 25.8 to 46.7), and the pooled mean mortality rate was 49.3%±2.2% (95% CI 45.0% to 53.5%). There was no significant difference in duration of hospital stay (p=0.528) or overall mortality (p=0.111), but a significant difference was observed in the mean length of ICU stay (2.8 days, p<0.001), between patients with and without Candida albicans. Meta-regression analysis found that South American patients had longer duration of ICU admission prior to candidaemia onset than patients elsewhere, while those in Asia had the shortest duration.ConclusionsPatients with IC are associated with longer ICU stay, with the shortest duration of ICU admission prior to the candidaemia onset in Asia. This shows a more proactive strategy in the diagnosis of IC should be considered in caring for ICU patients.

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