scholarly journals Patients Admitted to Three Spanish Intensive Care Units for Poisoning: Type of Poisoning, Mortality, and Functioning of Prognostic Scores Commonly Used

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
María Esther Banderas-Bravo ◽  
Maria Dolores Arias-Verdú ◽  
Ines Macías-Guarasa ◽  
Eduardo Aguilar-Alonso ◽  
Encarnación Castillo-Lorente ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Glasgow Coma Scale ◽  
Multicentre Study ◽  
Apache Ii ◽  
Prognostic Scores ◽  
Icu Mortality ◽  
Saps 3 ◽  
Apache Iii ◽  
Lemeshow Test

Objectives. To evaluate the gravity and mortality of those patients admitted to the intensive care unit for poisoning. Also, the applicability and predicted capacity of prognostic scales most frequently used in ICU must be evaluated. Methods. Multicentre study between 2008 and 2013 on all patients admitted for poisoning. Results. The results are from 119 patients. The causes of poisoning were medication, 92 patients (77.3%), caustics, 11 (9.2%), and alcohol, 20 (16,8%). 78.3% attempted suicides. Mean age was 44.42 ± 13.85 years. 72.5% had a Glasgow Coma Scale (GCS) ≤8 points. The ICU mortality was 5.9% and the hospital mortality was 6.7%. The mortality from caustic poisoning was 54.5%, and it was 1.9% for noncaustic poisoning (p<0.001). After adjusting for SAPS-3 (OR: 1.19 (1.02–1.39)) the mortality of patients who had ingested caustics was far higher than the rest (OR: 560.34 (11.64–26973.83)). There was considerable discrepancy between mortality predicted by SAPS-3 (26.8%) and observed (6.7%) (Hosmer-Lemeshow test: H=35.10; p<0.001). The APACHE-II (7,57%) and APACHE-III (8,15%) were no discrepancies. Conclusions. Admission to ICU for poisoning is rare in our country. Medication is the most frequent cause, but mortality of caustic poisoning is higher. APACHE-II and APACHE-III provide adequate predictions about mortality, while SAPS-3 tends to overestimate.

scholarly journals The Effects of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Prognostic Markers in Determining the Mortality in Patients Diagnosed With Pneumonia in Intensive Care

2021 ◽  
Author(s):  
Ömer Faruk Altaş ◽  
Mehmet Kızılkaya
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Risk ◽  
Demographic Data ◽  
Apache Ii ◽  
Prognostic Scores ◽  
Characteristic Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Point Increase

Objective: In this study, we aimed to reveal the level of predicting mortality of the Neutrophil/Lymphocyte (NLR) and Platelet/Lymphocyte Ratios (TLR) calculated in patients hospitalized with the diagnosis of pneumonia in the intensive care unit when compared with other prognostic scores. Method: The hospital records of 112 patients who were admitted to the intensive care unit between January 2015 and January 2018 and met the inclusion criteria were retrospectively reviewed. The patients’ demographic data, the NLR and PLR levels, and the APACHE II (Acute Physiology and Chronic Health Evaluation II) and SOFA (Sequential Organ Failure Assessment) scores were calculated from the patient files. Results: Of the 112 patients examined, 70 were males. The risk analysis showed that the male gender had 2.7 times higher risk of mortality. The NLR, PLR, APACHE II, and SOFA values were found statistically significant in predicting mortality (p<0.001). An evaluation of the risk ratios demonstrated that each one point increase in the NLR increased the mortality risk by 5%, and each one point increase in the SOFA score increased the mortality risk by 13% (p<0.05). In the ROC (receiver operating characteristic) analysis, the NLR assessment proved to be the most powerful, most specific, and sensitive test. The cut-off values were 11.3 for the NLR, 227 for the PLR, 29.8 for the APACHE II scores, and 5.5 for the SOFA scores. Conclusion: We believe that NLR and PLR are strong and independent predictors of mortality that can be easily and cost-effectively tested.

scholarly journals Relationships between APACHE II and APACHE III Scores and Mortality Rate in Intensive Care Unit Patients

1999 ◽  
Vol 37 (5) ◽  
pp. 814
Author(s):  
Shin Ok Koh ◽  
Ki Jun Kim ◽  
Eun Chi Bang ◽  
Sung Won Na ◽  
Yong Taek Nam
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Apache Ii ◽  
Apache Iii

scholarly journals Serum potassium levels and outcomes in critically ill patients in the medical intensive care unit

2018 ◽  
Vol 46 (3) ◽  
pp. 1254-1262 ◽  
Author(s):  
Surat Tongyoo ◽  
Tanuwong Viarasilpa ◽  
Chairat Permpikul
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Serum Potassium ◽  
Critically Ill Patients ◽  
Medical Intensive Care Unit ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Icu Mortality ◽  
Medical Intensive Care

Objective To compare the outcomes of patients with and without a mean serum potassium (K+) level within the recommended range (3.5–4.5 mEq/L). Methods This prospective cohort study involved patients admitted to the medical intensive care unit (ICU) of Siriraj Hospital from May 2012 to February 2013. The patients’ baseline characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, serum K+ level, and hospital outcomes were recorded. Patients with a mean K+ level of 3.5 to 4.5 mEq/L and with all individual K+ values of 3.0 to 5.0 mEq/L were allocated to the normal K+ group. The remaining patients were allocated to the abnormal K+ group. Results In total, 160 patients were included. Their mean age was 59.3±18.3 years, and their mean APACHE II score was 21.8±14.0. The normal K+ group comprised 74 (46.3%) patients. The abnormal K+ group had a significantly higher mean APACHE II score, proportion of coronary artery disease, and rate of vasopressor treatment. An abnormal serum K+ level was associated with significantly higher ICU mortality and incidence of ventricular fibrillation. Conclusion Critically ill patients with abnormal K+ levels had a higher incidence of ventricular arrhythmia and ICU mortality than patients with normal K+ levels.

scholarly journals Prognostic factors and outcome of adult allogeneic hematopoietic stem cell transplantation patients admitted to intensive care unit during transplant hospitalization

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Christian S. Michel ◽  
Daniel Teschner ◽  
Irene Schmidtmann ◽  
Matthias Theobald ◽  
Beate Hauptrock ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Stem Cell ◽  
Intensive Care ◽  
Hematopoietic Stem Cell Transplantation ◽  
Apache Ii ◽  
Prognostic Scores ◽  
Apache Ii Score ◽  
Hematopoietic Stem ◽  
Short And Long Term

AbstractPatients undergoing allogeneic hematopoietic stem cell transplantation have a high morbidity and mortality, especially after admission to intensive care unit (ICU) during peri-transplant period. The objective of this study was to identify new clinical and biological parameters and validate prognostic scores associated with ICU, short-and long-term survival. Significant differences between ICU survivors and ICU non-survivors for the clinical parameters invasive mechanical ventilation, urine output, heart rate, mean arterial pressure, and amount of vasopressors have been measured. Among prognostic scores (SOFA, SAPSII, PICAT, APACHE II, APACHE IV) assessing severity of disease and predicting outcome of critically ill patients on ICU, the APACHE II score has shown most significant difference (p = 0.002) and the highest discriminative power (area under the ROC curve (AUC) 0.74). An elevated level of lactate at day of admission was associated with poor survival on ICU and the most significant independent parameter (p < 0.001). In our cohort kidney damage with low urine output has a highly relevant impact on ICU, short- and long-term overall survival. The APACHE II score was superior predicting ICU mortality compared to all other tested prognostic scores for patients on ICU during peri-transplant period.

scholarly journals Combination of APACHE Scoring Systems with Adductor Pollicis Muscle Thickness for the Prediction of Mortality in Patients Who Spend More Than One Day in the Intensive Care Unit

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Elahe Nematifard ◽  
Seyed Hossein Ardehali ◽  
Shaahin Shahbazi ◽  
Hassan Eini-Zinab ◽  
Zahra Vahdat Shariatpanahi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Scoring Systems ◽  
Roc Curves ◽  
Adductor Pollicis ◽  
Interquartile Range ◽  
Apache Ii ◽  
Adductor Pollicis Muscle ◽  
Prediction Of Mortality ◽  
Apache Iii

Background. The objective of the present study was to compare the ability of Acute Physiology and Chronic Health Evaluation (APACHE) scoring systems with the combination of an anthropometric variable score “adductor pollicis muscle (APM) thickness” to the APACHE systems in predicting mortality in the intensive care unit. Methods. A prospective observational study was conducted with the APM thickness in the dominant hand, and APACHE II and III scores were measured for each patient upon admission. Given scores for the APM thickness were added to APACHE score systems to make two composite scores of APACHE II-APM and APACHE III-APM. The accuracy of the two composite models and APACHE II and III systems in predicting mortality of patients was compared using the area under the ROC curve. Results. Three hundred and four patients with the mean age of 54.75 ± 18.28 years were studied, of which 96 (31.57%) patients died. Median (interquartile range) of APACHE II and III scores was 15 (12–20) and 47 (33–66), respectively. Median (interquartile range) of APM thickness was 15 (12–17) mm, respectively. The area under the ROC curves for the prediction of mortality was 0.771 (95% CI: 0.715–0.827), 0.802 (95% CI: 0.751–0.854), 0.851 (95% CI: 0.807–0.896), and 0.865 (95% CI: 0.822–0.908) for APACHE II, APACHE III, APACHE II-APM, and APACHE III-APM, respectively. Conclusion. Although improvements in the area under ROC curves were not statistically significant when the APM thickness added to the APACHE systems, but the numerical value added to AUCs are considerable.

scholarly journals Validation of APACHE II, APACHE III and SAPS II scores in in-hospital and one year mortality prediction in a mixed intensive care unit in Poland: a cohort study

2020 ◽  
Author(s):  
Szymon Czajka ◽  
Katarzyna Ziębińska ◽  
Konstanty Marczenko ◽  
Barbara Posmyk ◽  
Anna Szczepańska ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Diagnostic Accuracy ◽  
Mortality Prediction ◽  
Apache Ii ◽  
Post Discharge ◽  
Saps Ii ◽  
Apache Iii

Abstract Background. There are several scores used for in-hospital mortality prediction in critical illness. Their application in a local scenario requires validation to ensure appropriate diagnostic accuracy. Moreover, their use in assessing post-discharge mortality in intensive care unit (ICU) survivors has not been extensively studied. We aimed to validate APACHE II, APACHE III and SAPS II scores in short- and long-term mortality prediction in a mixed adult ICU in Poland. APACHE II, APACHE III and SAPS II scores, with corresponding predicted mortality ratios, were calculated for 303 consecutive patients admitted to a 10-bed ICU in 2016. Short-term (in-hospital) and long-term (12-month post-discharge) mortality was assessed. Results. Median APACHE II, APACHE III and SAPS II scores were 19 (IQR 12-24), 67 (36.5-88) and 44 (27-56) points, with corresponding in-hospital mortality ratios of 25.8% (IQR 12.1-46.0), 18.5% (IQR 3.8-41.8) and 34.8% (IQR 7.9-59.8). Observed in-hospital mortality was 35.6%. Moreover, 12-month post-discharge mortality reached 17.4%. All the scores predicted in-hospital mortality (p<0.05): APACHE II (AUC=0.78; 95%CI 0.73-0.83), APACHE III (AUC=0.79; 95%CI 0.74-0.84) and SAPS II (AUC=0.79; 95%CI 0.74-0.84); as well as mortality after hospital discharge (p<0.05): APACHE II (AUC=0.71; 95%CI 0.64-0.78), APACHE III (AUC=0.72; 95%CI 0.65-0.78) and SAPS II (AUC=0.69; 95%CI 0.62-0.76), with no statistically significant difference between the scores (p>0.05). The calibration of the scores was good. Conclusions. All the scores are acceptable predictors of in-hospital mortality. In the case of post-discharge mortality, their diagnostic accuracy is lower and of borderline clinical relevance. Further studies are needed to create scores estimating the long-term prognosis of subjects successfully discharged from the ICU.

scholarly journals Epidemiological Study of Patients Admitted in Intensive Care Unit with Severe Acute Respiratory Illness with a Possible Diagnosis of COVID19 (EPIC19), a Multicentre Study.

2021 ◽  
Author(s):  
Amarja Ashok Havaldar ◽  
Vinay Kumar ◽  
Balaji Vijayan ◽  
John Michael Raj ◽  
Tinku Thomas ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Proportional Hazard ◽  
Icu Mortality ◽  
Ventilator Support ◽  
Arterial Blood ◽  
Cox Proportional Hazard ◽  
History Of

Abstract BackgroundGlobal pandemic of COVID 19 has affected many countries. The initial epicenter was in China with gradual spread to various countries including India.For a developing country like India with limited resources and high population, it is worthwhile to know how these patients requiring intensive care admission were managed and the outcome of these patients. To address these issues, a prospective observational study was planned.Methods A multicenter study was conducted from June 2020 to December 2020 including 4 centers across India. Patients > 18 years of age admitted in the intensive care unit (ICU), with the diagnosis of COVID 19 pneumonia confirmed by reverse transcriptase –polymerase chain reaction (RT-PCR) or rapid antigen test (RAT) as applicable were included. Factors associated with ICU mortality were examined using multivariable logistic regression analysis and Cox proportional hazard model. ResultsOf 667 patients were included in the study. ICU mortality was 60 %. In multivariable analysis, history of cerebral vascular accident (CVA), day 1 acute physiology and chronic health evaluation (APACHE II) score, need for invasive ventilator support, minimum PO2, fluid balance and complications such as pneumothorax and arrhythmia during ICU admission were associated with mortality. Among these parameters, day 1 need for invasive ventilator support (odds ratio OR: 3.01(1.81, 5.00) and development of arrhythmia (OR 3.85 [1.56, 8.06]) had higher odds of mortality. Cox proportional hazard analysis showed, history of ischemic heart disease (IHD) (Hazard Ratio, HR 1.64, 95% CI:1.13, 2.38), day1 APACHE II (HR 1.03, 95% CI:1.00, 1.07), arterial blood gas (ABG) pH (HR 0.14, 95% CI:0.03, 0.56) and use of therapeutic anticoagulation (HR 0.42,95% CI:0.29, 0.61) as a predictor of 7 days ICU mortality. Daywise trend of ventilator parameters showed dynamic compliance was higher on day3 and 4 in survivors.ConclusionIn this cohort of ICU patients, ICU mortality was 60%. The reason for higher mortality could be the severity of illness as suggested by the day 1 PF ratio (109.31 [77.79-187.26]).Trial Registration-(IEC131/2020, CTRI/2020/06/025858).

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