scholarly journals The Interplay of Nutrition, Physical Activity, Severity of Illness, and Mortality in Critically Ill Burn Patients: Is There a Connection?

2019 ◽  
Vol 40 (6) ◽  
pp. 936-942
Author(s):  
Beth A Shields ◽  
Jennifer N Carpenter ◽  
Brenda D Bustillos ◽  
Alicia N Jordan ◽  
Kyle B Cunningham ◽  
...  
Keyword(s):  
Physical Activity ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Sequential Organ Failure Assessment ◽  
Critically Ill ◽  
Severity Of Illness ◽  
Nutritional Intake ◽  
Burn Patients ◽  
Assessment Scores ◽  
Failure Assessment

Abstract The purpose of this project was to evaluate the relationships between nutrition, physical activity levels (PALs), severity of illness (SOI), and survival in critically ill burn patients. We conducted a retrospective evaluation of consecutively admitted adult patients who had an intensive care unit stay ≥8 days after ≥20% TBSA burns. Linear regression was used to assess the association between SOI (sequential organ failure assessment scores) and PALs as well as between SOI and nutritional intake. After univariate analysis comparing survivors and nonsurvivors, factors with P < .10 were analyzed with multiple logistic regression. Characteristics of the 45 included patients were: 42 ± 15 years old, 37 ± 17% TBSA burns, 22% mortality. Factors independently associated with survival were burn size (negatively) (P = .018), height (positively) (P = .006), highest PAL during the first eight intensive care unit days (positively) (P = .016), and kcal balance during the fifth through the eighth intensive care unit days (positively) (P = .012). Sequential organ failure assessment scores had a significant (P < .001) but weak association with nutrition intake (R2 = 0.05) and PALs (R2 = 0.25). Higher nutritional intake and activity were significantly associated with lower mortality in critically ill burn patients. Given the weak associations between both nutritional intake and PALs with SOI, the primary barrier in achieving nutrition and activity goals was not SOI. We recommend that physical rehabilitation and nutritional intake be optimized in an effort to improve outcomes in critically ill burn patients.

scholarly journals The Comparison between Sepsis 1.0 and Sepsis 3.0 in Database of Severe Infection in Critical Illness: A Retrospective Study

2019 ◽  
Author(s):  
Wei Zhang ◽  
Yan Zheng ◽  
Juan Gu ◽  
Yan Kang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Sequential Organ Failure Assessment ◽  
Critically Ill ◽  
Predictive Validity ◽  
Critically Ill Patients ◽  
Severe Infection ◽  
Suspected Infection ◽  
Failure Assessment

Abstract Objective To compared the Sepsis 1.0 criterial with the Sepsis 3.0 criteria predict the efficacy of all-caused mortality of in-hospital in critically ill patients with severe infection. Design This is a retrospective and cohort study based on the database of severe infection. Setting A 48-bed general intensive care unit in affiliated hospital of University. Patients Critically ill patients with suspected infection based on the electronic health records from 1 January to 31 December, 2015. Interventions None. Measurements The variables of exposures included: quick sequential organ failure assessment (qSOFA), systemic inflammatory response syndrome (SIRS) score and sequential organ failure assessment (SOFA). Main outcomes and measures: for predictive validity, we found that the discrimination for hospital mortality was more common with sepsis than with uncomplicated infections. Results are reported as the area under the receiver operating characteristic curve (AUROC).Main Results In the primary cohort, 873 patients had suspected infection cohort (n=634), of whom 188 (29.7%) died; and with the non-infection cohort (n=239), 26 patients died (10.9%). Among intensive care unit (ICU) cases in the infection cohort, the predictive validity for hospital mortality was higher for Sepsis 3.0 (SOFA) criteria (AUROC=0.702; 95%CI, 0.665 −0.737; p≤0.01 for both) than for Sepsis 1.0 (SIRS) criteria (AUROC=0.533; 95% confidence interval [95%CI], 0.493−0.572). Conclusions In our study, we found the Sepsis 3.0 criteria is able to accurately predict the prognosis in critically ill patients with severe infection, and its predictive efficacy is superior to Sepsis 1.0 criteria.

scholarly journals Sepsis induced sequential organ failure assessment score as a prognostic marker in surgical sepsis: a study of 30 cases in 02 years

2021 ◽  
Vol 8 (2) ◽  
pp. 686
Author(s):  
Tushar Nagyan ◽  
Mriganko S. Ray ◽  
Priyanshu M. Varshney ◽  
Sarvpreet S. Malhi ◽  
Naresh A. Modi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Critically Ill ◽  
Sofa Score ◽  
Fine Tuning ◽  
Mortality And Morbidity ◽  
Failure Assessment

Background: For the last few decades critical care medicine has been reinventing and fine-tuning organ dysfunction grading to establish a survival scoring system to accurately predict survivality and organ salvageability of critically ill patient in intensive care unit (ICU). The sequential organ failure assessment (SOFA) score assesses the performance of several organ systems in the body and assigns a score, where higher the SOFA score, higher the likelihood of mortality and morbidity. Early prediction of outcome in surgical sepsis is very likely to aid suitable modification of management strategies 13. This may improve prognosis in such patients and prevent mortality to some extent.  Methods: Observational and prospective study of 30 cases, aged>18 years & patients admitted to post-operative ward and surgical intensive care unit (SICU) with suspected surgical infection, and with two or more criteria of SIRS. Results: In this study out of total 30 patients 63.3% patients survived and 36.6% succumbed to their illness. Our study depicted significant increase in mortality rate when the SOFA score was above 12. Ventilated patient showed a higher mortality rate. Delta, mean, total SOFA Score were statistically significant in our study.Conclusions: SOFA score is useful in predicting mortality and morbidity in critically ill patients, because has a strong correlation between a rise in the score and mortality in all stages of admission. In our study, out of 09 patients whose T0 SOFA score was very high (above 12) out of which 03 patients only survived.

scholarly journals Establishment of a prognostic model based on the Sequential Organ Failure Assessment score for patients with first-time acute myocardial infarction

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110119
Author(s):  
Shuai Zheng ◽  
Jun Lyu ◽  
Didi Han ◽  
Fengshuo Xu ◽  
Chengzhuo Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
Cardiovascular Events ◽  
Failure Assessment ◽  
First Time

Objective This study aimed to identify the prognostic factors of patients with first-time acute myocardial infarction (AMI) and to establish a nomogram for prognostic modeling. Methods We studied 985 patients with first-time AMI using data from the Multi-parameter Intelligent Monitoring for Intensive Care database and extracted their demographic data. Cox proportional hazards regression was used to examine outcome-related variables. We also tested a new predictive model that includes the Sequential Organ Failure Assessment (SOFA) score and compared it with the SOFA-only model. Results An older age, higher SOFA score, and higher Acute Physiology III score were risk factors for the prognosis of AMI. The risk of further cardiovascular events was 1.54-fold higher in women than in men. Patients in the cardiac surgery intensive care unit had a better prognosis than those in the coronary heart disease intensive care unit. Pressurized drug use was a protective factor and the risk of further cardiovascular events was 1.36-fold higher in nonusers. Conclusion The prognosis of AMI is affected by age, the SOFA score, the Acute Physiology III score, sex, admission location, type of care unit, and vasopressin use. Our new predictive model for AMI has better performance than the SOFA model alone.

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