A simplified acute physiology score in the prediction of acute organophosphate poisoning outcome in an intensive care unit

2007 ◽  
Vol 26 (8) ◽  
pp. 623-627 ◽  
Author(s):  
S. Shadnia ◽  
D. Darabi ◽  
A. Pajoumand ◽  
A. Salimi ◽  
M. Abdollahi
Keyword(s):  
Intensive Care ◽  
Simplified Acute Physiology Score ◽  
Acute Physiology Score ◽  
Organophosphate Poisoning ◽  
Poison Center ◽  
Survival Group ◽  
Icu Admission ◽  
Saps Ii ◽  
Saps Ii Score ◽  
The Impact

Organophosphate poisoning (OPP) occurs frequently and accounts for a large number of intoxication cases treated in intensive care units (ICU). Poisoning by these agents is a serious public health problem. Among pesticides, OPs are the main cause of poisoning and death in Loghman-Hakim Poison Center of Tehran, Iran. The aim of this study was to determine the impact of the Simplified Acute Physiology Score (SAPS II) in the prediction of mortality in patients with acute OPP requiring admission to the ICU of Loghman-Hakim Hospital Poison Center over a period of 12 months. This study was a prospective, case-control of records of patients with acute OPP admitted to the ICU between January 2006 and December 2006. The Demographic data were collected and SAPS II score was recorded. During the study period, 24 subjects were admitted to the ICU with acute OPP. All 24 patients (15 male) required endotracheal intubation and mechanical ventilation in addition to gastric decontamination and standard therapy with atropine and oximes and adequate hydration. Of these, 24 patients, eight (five male) died. SAPS II score was significantly higher in the non-survival group than the survival group. Mortality following acute OPP remains high despite adequate intensive care and specific therapy with atropine and oximes. One-third of the subjects needing intensive care die within the hospitalization period. SAPS II scores calculated within the first 24 hours were recognized as good prognostic indicator among patients with acute OPP that required ICU admission. It is concluded that SAPS II score above 11 within the first 24 hours is a predictor of poor outcome in patients with acute OPP requiring ICU admission. Human & Experimental Toxicology (2007) 26, 623—627

scholarly journals Maternal admissions to Intensive Care Units in France: trends in rates, causes and severity

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Y Barry ◽  
C Deneux-Tharaux ◽  
M Saucedo ◽  
V Goulet ◽  
I Guseva-Canu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Temporal Trends ◽  
Simplified Acute Physiology Score ◽  
Incidence Rates ◽  
Icu Admission ◽  
Admission Rates ◽  
Saps Ii ◽  
Saps Ii Score ◽  
Territorial Disparities ◽  
Discharge Database

Abstract Introduction Maternal intensive care unit admission (ICU) is an indicator of severe maternal morbidity. This study aimed to estimate rates of maternal ICU admission during or following pregnancy in France, and to describe the characteristics of women admitted, the severity of their condition, associated diagnoses, regional disparities, and temporal trends between 2010 and 2014. Methods Women hospitalised in France in ICU during pregnancy or up to 42 days after pregnancy between 2010 and 2014 were identified using the national hospital discharge database (PMSI-MCO). The Simplified Acute Physiology Score (SAPS II) was used to estimate the severity. Trends in incidence rates were quantified using percentages of average annual variation based on a Poisson regression model. Results In total, 16,011 women were admitted to ICU, representing an overall rate of 3.97 ‰ deliveries. The average annual decrease in this rate between 2010 and 2014 was 1.7% (IC95%:-2, 00%; -1, 45%; p < 0.0001) on average per year. The SAPS II score increased significantly from 18.4 in 2010 to 21.5 in 2014. Obstetrical hemorrhage (39.8%) and hypertensive complications during pregnancy (24.8%) were the most common reasons for admission. Within mainland France, we found notable disparities in maternal ICU admission rates between regions, from lowest in Pays-de-la-Loire region (2.69‰) to highest in Ile-de-France (5.05‰). Conclusions The rate of maternal ICU admission decreased from 2010 to 2014 in France, with a concomitant increase in case severity. Additional studies are needed to understand the territorial disparities identified in our study. Key messages The decreasing incidence of maternal ICU admission could be due to organisational changes with increased admission to intermediate care units. These changes have to be understood to accurately use maternal CU admission for maternal health surveillance.

Prognostic Factors for Neutropenic Patients Admitted to Intensive Care.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3900-3900
Author(s):  
Madalena Silva ◽  
Luisa Checa ◽  
Fatima Costa ◽  
Rui Moreno ◽  
Eduardo G. Silva ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Underlying Disease ◽  
Simplified Acute Physiology Score ◽  
Prognostic Impact ◽  
Saps Ii ◽  
Severity Scores ◽  
Saps Ii Score ◽  
Organ Failures ◽  
Neutropenic Patients

Abstract The admission of neutropenic patients (pts) to intensive care units (ICU) is controversial, especially when mechanical ventilation is required. Knowledge of the relative prognostic impact of factors related to the underlying disease and to the severity of acute organ failures might help avoiding futile admissions. We retrospectively assessed predictors of 30-day mortality in neutropenic (<1000/ul) pts referred from a single Hematology unit to the 2 ICUs of the institution over a 10-year period. Of 66 consecutive pts, median age 48 (15–73), 82% had acute leukemia (AL) and 21% were in complete remission (CR). On ICU admission 62% of the pts had a neutrophil count ≤500/ul; microbiologically documented infection was found in 42%. The main reason for ICU referral was severe sepsis or septic shock in 62% of the cases and respiratory failure in 38%. Seventy per cent of the pts were already on vasopressor agents. At ICU entry the median Simplified Acute Physiology Score (SAPS) II was 63 and 26% of pts had ≥ 2 acute organ system failures (OSF). Coma was present in 23%. Mechanical ventilation was eventually needed in 89% and dialysis in 9% of the pts. Mortality at 30 days was 73%. By univariate logistic regression analysis mortality was not significantly related to age, to status of underlying disease (CR vs no CR/not yet known) to duration of neutropenia nor to depth of neutropenia at entry (≤ 500 vs >500/ul). Pts who died were more likely to have non-M3 AL subtype vs M3 (p=0.037), to have ≥ 2 acute OSF vs < 2 (p=0.012) and a higher SAPS II score (p< 0.001). In multivariate analysis only the latter 2 variables remained significant. In conclusion, our data show that 27% of neutropenic pts admitted to ICUs are alive at 30 days; that selection for admission should not be based on the characteristics of the underlying malignancy; and that the 30-day mortality is highly predictable by initial acute illness severity scores.

Performance of the simplified acute physiology score III in acute organophosphate poisoning: A retrospective observational study

2017 ◽  
Vol 37 (3) ◽  
pp. 221-228 ◽  
Author(s):  
DH Lee ◽  
BK Lee
Keyword(s):  
Operating Characteristic ◽  
Characteristic Curve ◽  
Case Fatality ◽  
Simplified Acute Physiology Score ◽  
Acute Physiology Score ◽  
Apache Ii ◽  
Organophosphate Poisoning ◽  
Hospital Case ◽  
Saps Ii ◽  
Standardized Mortality Ratios

The performances of acute physiology and chronic health evaluation (APACHE) II and simplified acute physiology score (SAPS) II have previously been evaluated in acute organophosphate poisoning. We aimed to compare the performance of the SAPS III with those of the APACHE II and SAPS II, as well as to identify the best tool for predicting case fatality using the standardized mortality ratios (SMRs) in acute organophosphate poisoning. A retrospective analysis of organophosphate poisoning was conducted. The APACHE II, SAPS II, and SAPS III were calculated within 24 h of admission. Discrimination was evaluated by calculating the area under the receiver operating characteristic curve (AUROC). The SMRs were calculated as 95% confidence intervals (CIs). In total, 100 cases of organophosphate poisoning were included. The in-hospital case fatality was 19%. The median scores of the APACHE II, SAPS II, and SAPS III were 20.0 (10.0–27.0), 41.0 (28.0–54.8), and 53.0 (36.3–68.8), respectively. The AUROCs were not significantly different among the APACHE II (0.815; 95% CI, 0.712–0.919), SAPS II (0.820; 95% CI, 0.719–0.912), and SAPS III (0.850; 95% CI, 0.763–0.936). Based on these scores and in-hospital case fatality, the SMRs for the APACHE II, SAPS II, and SAPS III were 1.01 (95% CI, 0.50–2.72), 1.01 (95% CI, 0.54 -2.78), and 0.98 (95% CI, 0.33–1.99), respectively. The SAPS III provided a good discrimination and satisfactory calibration in acute organophosphate poisoning. It was therefore a useful tool in predicting case fatality in acute organophosphate poisoning, similar to the APACHE II and SAPS II.

scholarly journals Early Prediction of Seven-Day Mortality in Intensive Care Unit Using a Machine Learning Model: Results from the SPIN-UTI Project

2021 ◽  
Vol 10 (5) ◽  
pp. 992
Author(s):  
Martina Barchitta ◽  
Andrea Maugeri ◽  
Giuliana Favara ◽  
Paolo Marco Riela ◽  
Giovanni Gallo ◽  
...  
Keyword(s):  
Machine Learning ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Learning Algorithm ◽  
Area Under The Curve ◽  
Support Vector ◽  
Icu Admission ◽  
Risk Of Death ◽  
Saps Ii ◽  
Svm Algorithm

Patients in intensive care units (ICUs) were at higher risk of worsen prognosis and mortality. Here, we aimed to evaluate the ability of the Simplified Acute Physiology Score (SAPS II) to predict the risk of 7-day mortality, and to test a machine learning algorithm which combines the SAPS II with additional patients’ characteristics at ICU admission. We used data from the “Italian Nosocomial Infections Surveillance in Intensive Care Units” network. Support Vector Machines (SVM) algorithm was used to classify 3782 patients according to sex, patient’s origin, type of ICU admission, non-surgical treatment for acute coronary disease, surgical intervention, SAPS II, presence of invasive devices, trauma, impaired immunity, antibiotic therapy and onset of HAI. The accuracy of SAPS II for predicting patients who died from those who did not was 69.3%, with an Area Under the Curve (AUC) of 0.678. Using the SVM algorithm, instead, we achieved an accuracy of 83.5% and AUC of 0.896. Notably, SAPS II was the variable that weighted more on the model and its removal resulted in an AUC of 0.653 and an accuracy of 68.4%. Overall, these findings suggest the present SVM model as a useful tool to early predict patients at higher risk of death at ICU admission.

scholarly journals Validation of the Simplified Acute Physiology Score 3 Scoring System in a Korean Intensive Care Unit

2011 ◽  
Vol 52 (1) ◽  
pp. 59 ◽  
Author(s):  
So Yeon Lim ◽  
Cho Rom Ham ◽  
So Young Park ◽  
Suhyun Kim ◽  
Maeng Real Park ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Scoring System ◽  
Simplified Acute Physiology Score ◽  
Acute Physiology Score

Neutrophil-to-lymphocyte Ratio as a Predictor of Mortality in ICU Patients: An Analysis of MIMIC-III Database

2020 ◽  
Author(s):  
Xie Wu ◽  
Zhanhao Su ◽  
Qipeng Luo ◽  
Yinan Li ◽  
Hongbai Wang ◽  
...  
Keyword(s):  
Intensive Care ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Predictive Power ◽  
Inflammatory Marker ◽  
Survival Group ◽  
Icu Patients ◽  
Lymphocyte Ratio ◽  
Saps Ii ◽  
Death Group

Abstract Background: Identifying high-risk patients in intensive care unit (ICU) is very important because of the high mortality rate. Existing scoring systems are numerous but lack effective inflammatory markers. Our objective was to identify and evaluate a low-cost, easily accessible and effective inflammatory marker that can predict mortality in ICU patients.Methods: We conducted a retrospective study using data from the Medical Information Mart for Intensive Care III database. We first divided the patients into the survival group and the death group based on in-hospital mortality. Receiver operating characteristic analyses were performed to find the best inflammatory marker (i.e. neutrophil-to-lymphocyte ratio, NLR). We then re-divided the patients into three groups based on NLR levels. Univariate and multivariate logistic regression were performed to evaluate the association between NLR and mortality. The area under the curve (AUC), Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI) were used to assess whether the incorporate of NLR can improve the predictive power of existing predictive model. Results: A total of 21,822 patients were included in this study, with an in-hospital mortality rate of 14.43%. Among all inflammatory marker in routine blood test results, NLR had the best predictive ability, with a median (interquartile range) NLR of 5.40 (2.95, 10.46) in the survival group and 8.32 (4.25, 14.75) in the death group. We then re-divided the patients into low (≤1), medium (1-6) and high (≥6) groups based on NLR levels. Compared with the median NLR group, the in-hospital mortality rates were significantly higher in the low (odds ratio [OR] = 2.09; 95% confidence interval [CI], 1.64 to 2.66) and high (OR=1.64; 95%CI, 1.50-1.80) NLR groups. The addition of NLR to Simplified Acute Physiology Score II (SAPS II) improved the AUC from 0.789 to 0.798 (P<0.001), with NRI of 16.64% (P<0.001) and IDI of 0.27% (P<0.001).Conclusion: NLR is a good predictor of mortality in ICU patients, both low and high levels of NLR are associated with elevated mortality rate. The inclusion of NLR might improve the predictive power of SAPS II.

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