scholarly journals Time to antimicrobial therapy in septic shock patients treated with an early goal‐directed resuscitation protocol: A post‐hoc analysis of the ARISE trial

2020 ◽  
Author(s):  
Esther B Bulle ◽  
Sandra L Peake ◽  
Mark Finnis ◽  
Rinaldo Bellomo ◽  
Anthony Delaney ◽  
...  
Keyword(s):  
Septic Shock ◽  
Antimicrobial Therapy ◽  
Post Hoc Analysis ◽  
Post Hoc

scholarly journals Validation of the pediatric refractory septic shock definition: post hoc analysis of a controlled trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Luc Morin ◽  
Karthik Narayanan Ramaswamy ◽  
Muralidharan Jayashree ◽  
Arun Bansal ◽  
Karthi Nallasamy ◽  
...  
Keyword(s):  
Septic Shock ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Receiver Operating Curve ◽  
Double Blind ◽  
Post Hoc Analysis ◽  
Prognostic Accuracy ◽  
Refractory Septic Shock ◽  
Post Hoc

Abstract Background The European Society of Pediatric and Neonatal Intensive Care (ESPNIC) developed and validated a definition of pediatric refractory septic shock (RSS), based on two septic shock scores (SSS). Both bedside SSS (bSSS) and computed SSS (cSSS) were found to be strongly associated with mortality. We aimed at assessing the accuracy of the RSS definition on a prospective cohort from India. Methods Post hoc analysis of a cohort issued from a double-blind randomized trial that compared first-line vasoactive drugs in children with septic shock. Sequential bSSS and cSSS from 60 children (single-center study, 53% mortality) were analyzed. The prognostic value of the ESPNIC RSS definition was tested for 28-day all-cause mortality. Results In this septic shock cohort, RSS was diagnosed in 35 patients (58.3%) during the first 24 h. Death occurred in 30 RSS patients (85.7% mortality) and in 2 non-RSS patients (8% mortality), OR = 60.9 [95% CI: 10.5–676.2], p < 0.001 with a median delay from sepsis onset of 3 days [1.0–6.7]. Among patients diagnosed with RSS, the mortality was not significantly different according to vasopressors randomization. Diagnosis of RSS with bSSS and cSSS had a high discrimination for death with an area under the receiver operating curve of 0.916 [95% CI: 0.843–0.990] and 0.925 [95% CI: 0.845–1.000], respectively. High prognostic accuracy of the bSSS was found in the first hours following intensive care admission. The best interval of prognostication occurs after the 12th hour following treatment initiation (AUC 0.973 [95% CI: 0.925–1.000]). Conclusions The ESPNIC refractory septic shock definition accurately identifies, within the first 6 h of septic shock management, children with lethal outcome.

scholarly journals Hyperoxia toxicity in septic shock patients according to the Sepsis-3 criteria: a post hoc analysis of the HYPER2S trial

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Julien Demiselle ◽  
◽  
Martin Wepler ◽  
Clair Hartmann ◽  
Peter Radermacher ◽  
...  
Keyword(s):  
Septic Shock ◽  
Post Hoc Analysis ◽  
Post Hoc

Evolution of Blood Lactate and 90-Day Mortality in Septic Shock. A Post Hoc Analysis of the FINNAKI Study

Shock ◽  
2017 ◽  
Vol 47 (5) ◽  
pp. 574-581 ◽  
Author(s):  
Elina Varis ◽  
Ville Pettilä ◽  
Meri Poukkanen ◽  
Stephan M. Jakob ◽  
Sari Karlsson ◽  
...  
Keyword(s):  
Septic Shock ◽  
Blood Lactate ◽  
Post Hoc Analysis ◽  
Post Hoc

Association between fluid balance and mortality in patients with septic shock: a post hoc analysis of the TRISS trial

2016 ◽  
Vol 60 (7) ◽  
pp. 925-933 ◽  
Author(s):  
M. Cronhjort ◽  
P. B. Hjortrup ◽  
L. B. Holst ◽  
E. Joelsson-Alm ◽  
J. Mårtensson ◽  
...  
Keyword(s):  
Septic Shock ◽  
Fluid Balance ◽  
Post Hoc Analysis ◽  
Post Hoc

scholarly journals Effect of Clinically Uninfected Orthopedic Implants and Pacemakers/AICDs in Low-Risk Staphylococcus aureus Bloodstream Infection on Crude Mortality Rate: A Post Hoc Analysis of a Large Cohort Study

2019 ◽  
Vol 6 (5) ◽  
Author(s):  
Achim J Kaasch ◽  
Winfried V Kern ◽  
Insa Joost ◽  
Martin Hellmich ◽  
Harald Seifert ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Mortality Rate ◽  
Antimicrobial Therapy ◽  
Treatment Duration ◽  
Foreign Bodies ◽  
Hazard Ratio ◽  
Low Risk ◽  
Post Hoc Analysis ◽  
Risk Patients ◽  
Post Hoc

Abstract Background The standard treatment duration in low-risk Staphylococcus aureus bloodstream (SAB) is 14 days. However, it is unclear whether an extended course of antimicrobial therapy is necessary in patients with clinically uninfected prosthetic joints/osteosyntheses or pacemakers/automated implanted cardioverter-defibrillators (AICDs). Thus, we compared the duration of antimicrobial therapy and outcomes in patients with and those without clinically uninfected foreign bodies. Methods We conducted a post hoc analysis of data from the prospective Invasive Staphylococcus aureus Infection Cohort (INSTINCT) study. Adult low-risk patients who survived ≥4 days were assessed for duration of treatment, SAB-related events (attributable death, relapse, or new deep-seated infection), and survival. Results Of the 1288 patients enrolled, 292 satisfied criteria for low-risk SAB. Forty-three patients (15%) had a clinically uninfected pacemaker/AICD or orthopedic implant. Patients with foreign bodies were significantly older (mean age, 72 vs 62 years for those without; P &lt; .001; P = .9) and had a higher Charlson score (median, 3 vs 2; P = .06). The total duration of antimicrobial therapy (median, 18 vs 17 days, respectively; P = .7), all-cause mortality rate (16% vs 14%; P = .7), and prevalence of SAB-related events within 90 days were similar (2% vs 2%) in the 2 groups. At 1-year follow-up, SAB-related events were more frequent in patients with foreign bodies (7% vs 4% in those without; P = .4) (hazard ratio, 1.41; 95% confidence interval, .35–5.69; in a multivariable Cox model), but this difference was not statistically significant. Conclusions Low-risk patients with clinically uninfected foreign bodies received a similar duration of antimicrobial therapy without a significant impact on mortality rate. The observed higher hazard ratio of SAB-related events within 1 year necessitates additional studies before recommendations concerning treatment duration in this patient subgroup can be adapted or modified.

Cardiovascular clusters in septic shock combining clinical and echocardiographic parameters: a post hoc analysis

2019 ◽  
Vol 45 (5) ◽  
pp. 657-667 ◽  
Author(s):  
Guillaume Geri ◽  
Philippe Vignon ◽  
Alix Aubry ◽  
Anne-Laure Fedou ◽  
Cyril Charron ◽  
...  
Keyword(s):  
Septic Shock ◽  
Post Hoc Analysis ◽  
Echocardiographic Parameters ◽  
Post Hoc

scholarly journals Gender differences in mortality and quality of life after septic shock: A post-hoc analysis of the ARISE study

2020 ◽  
Vol 55 ◽  
pp. 177-183 ◽  
Author(s):  
Nora Luethi ◽  
Michael Bailey ◽  
Alisa Higgins ◽  
Belinda Howe ◽  
Sandra Peake ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gender Differences ◽  
Septic Shock ◽  
Post Hoc Analysis ◽  
Post Hoc
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