scholarly journals Mortality Prediction Model of Septic Shock Patients Based on Routinely Recorded Data

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Marta Carrara ◽  
Giuseppe Baselli ◽  
Manuela Ferrario
Keyword(s):  
Septic Shock ◽  
Clinical Information ◽  
Mortality Prediction ◽  
Shock Onset ◽  
The Public ◽  
Hemodynamic Variables ◽  
Mortality Prediction Model ◽  
Critical Care Management ◽  
Recorded Data ◽  
Preliminary Study

We studied the problem of mortality prediction in two datasets, the first composed of 23 septic shock patients and the second composed of 73 septic subjects selected from the public database MIMIC-II. For each patient we derived hemodynamic variables, laboratory results, and clinical information of the first 48 hours after shock onset and we performed univariate and multivariate analyses to predict mortality in the following 7 days. The results show interesting features that individually identify significant differences between survivors and nonsurvivors and features which gain importance only when considered together with the others in a multivariate regression model. This preliminary study on two small septic shock populations represents a novel contribution towards new personalized models for an integration of multiparameter patient information to improve critical care management of shock patients.

scholarly journals Development and performance of a novel vasopressor-driven mortality prediction model in septic shock

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Saraschandra Vallabhajosyula ◽  
Jacob C. Jentzer ◽  
Aditya A. Kotecha ◽  
Dennis H. Murphree ◽  
Erin F. Barreto ◽  
...  
Keyword(s):  
Septic Shock ◽  
Prediction Model ◽  
Mortality Prediction ◽  
Mortality Prediction Model ◽  
And Performance

scholarly journals Timing Assessment of Response to Fluid Challenge in Patients with Septic Shock

2021 ◽  
Author(s):  
Hui-bin Huang ◽  
Biao Xu ◽  
Guang-Yun Liu ◽  
Bin Du
Keyword(s):  
Septic Shock ◽  
Repeated Measures ◽  
Time Course ◽  
Fluid Challenge ◽  
Time Points ◽  
Initial Resuscitation ◽  
Hemodynamic Variables ◽  
Assessment Time ◽  
Recorded Data ◽  
Time Courses

Abstract Objectives: Fluid challenge (FC) is most commonly used for fluid responsiveness (FR) evaluation, with a wide divergence in assessment time choices. Therefore, we aimed to explore the optimal assessment time for FC in patients with septic shock. Methods: A prospective cohort study was conducted. Septic shock patients who had experienced initial resuscitation and required an FC with 500 mL 4% gelatin or normal saline (NS) over 5-10 min were included. FR was defined by an increase in cardiac index (CI) >10%. FR and other predefined variables were recorded at baseline (Tb), immediately (T0), and at 10 (T1), 30 (T2), 45 (T3), 60 (T4), 90 (T5), and 120 (T6) min after FC. The incidence of FR and hemodynamic variables at predefined time points were recorded. Data were analyzed by repeated measures of analysis of variance. Results: 63 patients were enrolled, with 43 in the gelatin group and 20 in the NS group. Among the 45/63 (71%) responders, 31 were responded at T0 (ER), while 14 responded at T1 or later (LR). The proportion of NR, ER and LR was comparable between gelatin and NS groups. After FC, the time course of FR status was slightly different between gelatin and NS groups. In the gelatin group, FC induced most responders (69%, 31/45) and frequency of CI maximum (35%, 11/31) at T2 and sustained a positive FR status until T4; while in the NS group, FC induced most responders (55%, 11/20) and frequency of CI maximum (64%, 9/14) at T1, and sustained FR status until T1. Conclusions: Different time courses of FR were found between gelatin and NS group patients undergoing FC. Thus, when NS is used, FR should be performed within 10 min, while it is better to extend the assessment time to 30 min after FC when gelatin is used.

scholarly journals Mortality prediction using a novel combination of biomarkers in the first day of sepsis in intensive care units

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Junkun Liu ◽  
Chengwen Bai ◽  
Binbin Li ◽  
Aijun Shan ◽  
Fei Shi ◽  
...  
Keyword(s):  
Septic Shock ◽  
Scoring Systems ◽  
Predictive Performance ◽  
Serum Levels ◽  
International Normalized Ratio ◽  
Individual Performance ◽  
Mortality Prediction ◽  
New Combination ◽  
Thrombin Time ◽  
Survivor Group

AbstractEarly identification of infection severity and organ dysfunction is crucial in improving outcomes of patients with sepsis. We aimed to develop a new combination of blood-based biomarkers that can early predict 28-day mortality in patients with sepsis or septic shock. We enrolled 66 patients with sepsis or septic shock and compared 14 blood-based biomarkers in the first 24 h after ICU admission. The serum levels of interleukin-6 (IL-6) (median 217.6 vs. 4809.0 pg/ml, P = 0.001), lactate (median 2.4 vs. 6.3 mmol/L, P = 0.014), N-terminal prohormone of brain natriuretic peptide (NT-proBNP) (median 1596.5 vs. 32,905.3 ng/ml, P < 0.001), prothrombin time (PT) (median 15.6 vs. 20.1 s, P = 0.030), activated partial thrombin time (APTT) (median 45.1 vs. 59.0 s, P = 0.026), and international normalized ratio (INR) (median 1.3 vs. 1.8, P < 0.001) were significantly lower in the survivor group. IL-6, NT-proBNP, and INR provided the best individual performance in predicting 28-day mortality of patients with sepsis or septic shock. Furthermore, the combination of these three biomarkers achieved better predictive performance (AUC 0.890, P < 0.001) than conventional scoring systems. In summary, the combination of IL-6, NT-proBNP, and INR may serve as a potential predictor of 28-day mortality in critically ill patients with sepsis or septic shock.

Comparing Primary Voice-Hearers with and without Hallucinations in Other Sensory Modalities

2021 ◽  
pp. 214-220
Author(s):  
Wei Lin Toh ◽  
Neil Thomas ◽  
Susan L. Rossell
Keyword(s):  
Functional Impairment ◽  
Auditory Hallucination ◽  
Sensory Modality ◽  
Clinical Information ◽  
Auditory Hallucinations ◽  
Auditory Modality ◽  
Positive Symptoms ◽  
Psychotic Experiences ◽  
Sensory Modalities ◽  
Preliminary Study

There has been burgeoning interest in studying hallucinations in psychosis occurring across multiple sensory modalities. The current study aimed to characterize the auditory hallucination and delusion profiles in patients with auditory hallucinations only versus those with multisensory hallucinations. Participants with psychosis were partitioned into groups with voices only (AVH; <i>n</i> = 50) versus voices plus hallucinations in at least one other sensory modality (AVH+; <i>n</i> = 50), based on their responses on the Scale for the Assessment of Positive Symptoms (SAPS). Basic demographic and clinical information was collected, and the Questionnaire for Psychotic Experiences (QPE) was used to assess psychosis phenomenology. Relative to the AVH group, greater compliance to perceived commands, auditory illusions, and sensed presences was significantly elevated in the AVH+ group. The latter group also had greater levels of delusion-related distress and functional impairment and was more likely to endorse delusions of reference and misidentification. This preliminary study uncovered important phenomenological differences in those with multisensory hallucinations. Future hallucination research extending beyond the auditory modality is needed.

scholarly journals Initial Diagnostic Workup of Acute Leukemia: Guideline From the College of American Pathologists and the American Society of Hematology

2017 ◽  
Vol 141 (10) ◽  
pp. 1342-1393 ◽  
Author(s):  
Daniel A. Arber ◽  
Michael J. Borowitz ◽  
Melissa Cessna ◽  
Joan Etzell ◽  
Kathryn Foucar ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Acute Leukemia ◽  
Lymphoblastic Leukemia ◽  
Molecular Genetic ◽  
Clinical Information ◽  
Molecular Genetic Testing ◽  
Acute Leukemias ◽  
Prognostic Evaluation ◽  
The Public ◽  
American Society

Context.— A complete diagnosis of acute leukemia requires knowledge of clinical information combined with morphologic evaluation, immunophenotyping and karyotype analysis, and often, molecular genetic testing. Although many aspects of the workup for acute leukemia are well accepted, few guidelines have addressed the different aspects of the diagnostic evaluation of samples from patients suspected to have acute leukemia. Objective.— To develop a guideline for treating physicians and pathologists involved in the diagnostic and prognostic evaluation of new acute leukemia samples, including acute lymphoblastic leukemia, acute myeloid leukemia, and acute leukemias of ambiguous lineage. Design.— The College of American Pathologists and the American Society of Hematology convened a panel of experts in hematology and hematopathology to develop recommendations. A systematic evidence review was conducted to address 6 key questions. Recommendations were derived from strength of evidence, feedback received during the public comment period, and expert panel consensus. Results.— Twenty-seven guideline statements were established, which ranged from recommendations on what clinical and laboratory information should be available as part of the diagnostic and prognostic evaluation of acute leukemia samples to what types of testing should be performed routinely, with recommendations on where such testing should be performed and how the results should be reported. Conclusions.— The guideline provides a framework for the multiple steps, including laboratory testing, in the evaluation of acute leukemia samples. Some aspects of the guideline, especially molecular genetic testing in acute leukemia, are rapidly changing with new supportive literature, which will require on-going updates for the guideline to remain relevant.

Incorporating initial treatments improves the performance of a mortality prediction model based on administrative data

2012 ◽  
Vol 40 (7) ◽  
pp. 2268-2269 ◽  
Author(s):  
Tara Lagu ◽  
Thomas L. Higgins ◽  
Brian H. Nathanson ◽  
Peter K. Lindenauer
Keyword(s):  
Prediction Model ◽  
Administrative Data ◽  
Mortality Prediction ◽  
Model Based ◽  
Mortality Prediction Model
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