scholarly journals A retrospective study of sepsis-associated encephalopathy: epidemiology, clinical features and adverse outcomes

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jiayi Chen ◽  
Xiaobei Shi ◽  
Mengyuan Diao ◽  
Guangyong Jin ◽  
Ying Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Clinical Features ◽  
Sofa Score ◽  
Adverse Outcomes ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Gastrointestinal Infections ◽  
Independent Risk Factors ◽  
Poor Outcomes

Abstract Background Sepsis-associated encephalopathy (SAE) is a common complication of sepsis that may result in worse outcomes. This study was designed to determine the epidemiology, clinical features, and risk factors of SAE. Methods This was a retrospective study of all patients with sepsis who were admitted to the Critical Care Medicine Department of Hangzhou First People’s Hospital Affiliated with Zhejiang University School of Medicine from January 2015 to December 2019. Results A total of 291 sepsis patients were screened, and 127 (43.6%) were diagnosed with SAE. There were significant differences in median age, proportion of underlying diseases such as hypertension, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, gastrointestinal infections, detection rate of Enterococcus, and 28-day mortality between the SAE and non-SAE groups. Both the SOFA score and APACHE II score were independent risk factors for SAE in patients with sepsis. All 127 SAE patients were divided into survival and non-survival groups. The age, SOFA score, and APACHE II score were independently associated with 28-day mortality in SAE patients. Conclusion In the present retrospective study, nearly half of patients with sepsis developed SAE, which was closely related to poor outcomes. Both the SOFA score and APACHE II score were independent risk factors for predicting the occurrence and adverse outcome of SAE.

scholarly journals Patients With Perforated Peptic Ulcers: Risk Factors for Morbidity and Mortality

2019 ◽  
Vol 103 (11-12) ◽  
pp. 578-584
Author(s):  
Fatih Ciftci ◽  
Fazilet Erözgen
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Postoperative Period ◽  
Perforated Peptic Ulcer ◽  
Apache Ii ◽  
Morbidity And Mortality ◽  
Apache Ii Score ◽  
Peptic Ulcers ◽  
Presentation Time ◽  
Independent Risk Factors

Perforated peptic ulcers continue to be an important problem in surgical practice. In this study, risk factors for peptic ulcer perforation-associated mortality and morbidity were evaluated. This is a retrospective study of patients surgically treated for perforated peptic ulcer over a decade (March 1999–December 2014). Patient age, sex, complaints at presentation, time lapse between onset of complaints and presentation to the hospital, physical findings, comorbidities, laboratory and imaging findings, length of hospitalization, morbidity, and mortality were recorded. The Mannheim peritonitis index (MPI) and Acute Physiology and Chronic Health Evaluation (APACHE) II score were calculated and recorded for each patient on admission to the hospital. Of the 149 patients, mean age was 50.6 ± 19 years (range: 17–86). Of these, 129 (86.5%) were males and 20 (13.4%) females. At least 1 comorbidity was found in 42 (28.1%) of the patients. Complications developed in 36 (24.1%) of the patients during the postoperative period. The most frequent complication was wound site infection. There was mortality in 26 (17.4%) patients and the most frequent cause of mortality was sepsis. Variables that were found to have statistically significant effects on morbidity included age older than 60 years, presence of comorbidities, and MPI (P = 0.029, 0.013, and 0.013, respectively). In a multivariate analysis, age older than 60 years, presence of comorbidities, and MPI were independent risk factors that affected morbidity. In the multivariate logistic regression analysis, age older than 60 years [P = 0.006, odds ratio (OR) = 5.99, confidence interval (CI) = 0.95] and comorbidities (OR = 2.73, CI = 0.95) were independent risk factors that affected morbidity. MPI and APACHE II scoring were both predictive of mortality. Age older than 60, presentation time, and MPI were independent risk factors for mortality. Undelayed diagnosis and appropriate treatment are of the utmost importance when presenting with a perforated peptic ulcer. We believe close observation of high-risk patients during the postoperative period may decrease morbidity and mortality rates.

scholarly journals Risk factors for mortality in critically ill patients with COVID-19: a multicenter retrospective case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jinghua Gao ◽  
Li Zhong ◽  
Ming Wu ◽  
Jingjing Ji ◽  
Zheying Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Organ Failure ◽  
Critically Ill ◽  
Sofa Score ◽  
Lymphocyte Count ◽  
Cox Regression ◽  
Survival Curve ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Hospital Death

Abstract Background Coronavirus disease 2019 (COVID-19) has spread around the world, until now, the number of positive and death cases is still increasing. Therefore, it remains important to identify risk factors for death in critically patients. Methods We collected demographic and clinical data on all severe inpatients with COVID-19. We used univariable and multivariable Cox regression methods to determine the independent risk factors related to likelihood of 28-day and 60-day survival, performing survival curve analysis. Results Of 325 patients enrolled in the study, Multi-factor Cox analysis showed increasing odds of in-hospital death associated with basic illness (hazard ratio [HR] 6.455, 95% Confidence Interval [CI] 1.658–25.139, P = 0.007), lymphopenia (HR 0.373, 95% CI 0.148–0.944, P = 0.037), higher Sequential Organ Failure Assessment (SOFA) score on admission (HR 1.171, 95% CI 1.013–1.354, P = 0.033) and being critically ill (HR 0.191, 95% CI 0.053–0.687, P = 0.011). Increasing 28-day and 60-day mortality, declining survival time and more serious inflammation and organ failure were associated with lymphocyte count < 0.8 × 109/L, SOFA score > 3, Acute Physiology and Chronic Health Evaluation II (APACHE II) score > 7, PaO2/FiO2 < 200 mmHg, IL-6 > 120 pg/ml, and CRP > 52 mg/L. Conclusions Being critically ill and lymphocyte count, SOFA score, APACHE II score, PaO2/FiO2, IL-6, and CRP on admission were associated with poor prognosis in COVID-19 patients.

scholarly journals Risk factors and prognosis of hypoalbuminemia in surgical septic patients

PeerJ ◽  
2015 ◽  
Vol 3 ◽  
pp. e1267 ◽  
Author(s):  
Jia-Kui Sun ◽  
Fang Sun ◽  
Xiang Wang ◽  
Shou-Tao Yuan ◽  
Shu-Yun Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Lactate ◽  
Early Stage ◽  
Albumin Level ◽  
Multiple Organ ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Reactive Protein ◽  
Retrospective Clinical Study ◽  
Independent Risk Factors

The aim of this study was to investigate the risk factors of hypoalbuminemia and effects of different albumin levels on the prognosis of surgical septic patients. We preformed a retrospective clinical study including 135 adult patients from September 2011 to June 2014. The albumin levels and severity markers were recorded during the first 48 h after enrollment, and logistic regression analyses were used to determine the risk factors. The outcomes of patients with different albumin levels were also compared. The acute physiology and chronic health evaluation II (APACHE II) score (OR 1.786, 95% CI [1.379–2.314],P< 0.001), C-reactive protein (CRP) (OR 1.016, 95% CI [1.005–1.027],P= 0.005), and blood lactate (OR 1.764, 95% CI [1.141–2.726],P= 0.011) were established as the independent risk factors of hypoalbuminemia in patients with surgical sepsis. The severity markers and outcomes of patients with albumin levels ≤20 g/L were significantly worse than that of 21–25 g/L and ≥26 g/L, whereas the latter two groups had similar prognosis. Every 1 g/L decrease of albumin level below the optimal cut-off (23 g/L) was associated with a 19.4% increase in hospital mortality and a 28.7% increase in the incidence of multiple organ dysfunction syndrome. In conclusion, APACHE II score (≥14.5), CRP (≥34.25 mg/L), and blood lactate (≥.35 mmol/L) were established as the independent risk factors of hypoalbuminemia in the early stage of surgical sepsis. Patients with baseline albumin level ≤20 g/L had worse prognosis than that of albumin level ≥21 g/L. Albumin levels were negatively correlated the prognosis of surgical sepsis when below about 23 g/L.

scholarly journals Analysis of Risk Factors For Sepsis And Indicators of Prognosis In Patients With Sepsis: A Retrospective Observational Study

2021 ◽  
Author(s):  
Huifeng Wang ◽  
Zhiling Zhao ◽  
Zhao-hui Tong
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Albumin Level ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Multivariate Logistic Regression ◽  
Independent Risk Factors

Abstract Background: To investigate the independent risk factors for sepsis and the prognostic indicators of sepsis-related mortality to guide clinical practice.Methods: Adult patients diagnosed with sepsis in the respiratory intensive care unit (RICU), emergency ICU (EICU), and surgical ICU (SICU) of Beijing Chao-Yang Hospital, Capital Medical University, from January 2016 to April 2021 were enrolled. Comorbidities, complications, and laboratory indicators were retrospectively analyzed. Variables with a p value < 0.05 in the univariate analysis were entered into multivariate logistic regression analysis to identify the independent risk factors for sepsis. Receiver operating characteristic curve (ROC) analysis was used for those variables with P < 0.05 in multivariate regression to evaluate the fit of the predictive model and its prognostic efficacy. Results: A total of 123 adult patients with sepsis were enrolled, with 80 males and 43 females and a mean age of 61.56 ± 17.12 years. Acute respiratory distress syndrome (ARDS) occurred in 84 patients (68.3%), acute kidney injury (AKI) occurred in 28 patients (22.8%), acute myocardial injury (AMI) occurred in 6 patients (4.9%), disseminated intravascular coagulation (DIC) occurred in 14 patients (11.4%), septic shock occurred in 40 patients (32.5%), and 41 patients (33.3%) died. Multivariate logistic regression analysis showed that mean arterial pressure (MAP), acute physiology and chronic health evaluation II (APACHE II) score, albumin level, and the presence of DIC were independent risk factors for sepsis (P < 0.05). The area under the ROC curve for the model including MAP, albumin, and APACHE II score was the highest at 0.890.Conclusion: The MAP, APACHE II score, albumin level, and DIC were independent risk factors for sepsis. The inclusion of the MAP, albumin level, and APACHE II score in the model yielded the most accurate prediction of the risk of mortality.

scholarly journals Risk Factors for Mortality in Critically Ill Patients with COVID-19: A Multicenter Retrospective Case-Control Study

2020 ◽  
Author(s):  
Jinghua Gao ◽  
Li Zhong ◽  
Ming Wu ◽  
Jingjing Ji ◽  
Ziyun Shao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Organ Failure ◽  
Critically Ill ◽  
Sofa Score ◽  
Lymphocyte Count ◽  
Cox Regression ◽  
Survival Curve ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Hospital Death

Abstract Background Coronavirus disease 2019 (COVID-19) has spread around the world and caused many deaths, but little is known about the risk factors for death in critically patients. Methods we collected demographic and clinical data on all severe inpatients with COVID-19 .We used univariable and multivariable Cox regression methods to determine the independent risk factors related to likelihood of 28-day and 60-day survival, performing survival curve analysis. Results Of 325 patients enrolled in the study, Multi-factor Cox analysis showed increasing odds of in-hospital death associated with basic illness (hazard ratio [HR] 6.455, 95% Confidence Interval [CI] 1.658–25.139, P = 0.007), lymphopenia (HR 0.373, 95% CI 0.148–0.944, P = 0.037), higher Sequential Organ Failure Assessment (SOFA) score on admission (HR 1.171, 95% CI 1.013–1.354, P = 0.033) and being critically ill (HR 0.191, 95% CI 0.053–0.687, P = 0.011). Increasing 28-day and 60-day mortality, declining survival time and more serious inflammation and organ failure were associated with lymphocyte count ≤ 0.8 × 109/L, SOFA score > 3, Acute Physiology and Chronic Health Evaluation II (APACHE II) score > 7, PaO2/FiO2 ≤ 200 mmHg, IL-6 > 120 pg/ml, and CRP > 52 mg/L. Conclusions Being critically ill and lymphocyte count, SOFA score, APACHE II score, PaO2/FiO2, IL-6, and CRP on admission were associated with poor prognosis in COVID-19 patients.

scholarly journals The prognostic factors in sepsis patients after operation of gastrointestinal tumors in ICU

2020 ◽  
Author(s):  
Ren-Xiong Chen ◽  
Zhou-Qiao Wu ◽  
Zi-Yu Li ◽  
Hong-Zhi Wang ◽  
Jia-Fu Ji
Keyword(s):  
Risk Factors ◽  
Lactic Acid ◽  
Prognostic Factors ◽  
Protective Factor ◽  
Univariate Analysis ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Tumor Surgery ◽  
Gastrointestinal Tumor ◽  
Independent Risk Factors

Abstract Background: We studied the clinical profiles and the prognostic factors in patients with sepsis after the gastrointestinal tumor surgery in ICU.Methods: We retrospectively screened patients who underwent the gastrointestinal tumor surgery at the Peking University Cancer Hospital from January, 2015 to December, 2019. Among them, 181 patients who were diagnosed with sepsis in ICU were enrolled in our study. Cox regression was performed for multivariate adjusted factor analyses.Results: The 90-day all-cause mortality rate was 11.1% in our study. The univariate analysis showed that BMI, shock within 48 h after entering ICU, number of blood leukocytes, ratio of lymphocytes to neutrophils, INR, creatinine, procalcitonin, lactic acid, oxygenation index, SOFA score within 24 h after entering ICU, APACHE II score within 24 h after entering ICU were statistically significant. In multiple analysis, we found that BMI༞20 kg/m2 was a protective factor, while lactic acid༞3 mmol/L after entering ICU and APACHE II score༞20 within 24 h after entering ICU were independent risk factors for the prognosis of sepsis after the gastrointestinal tumor surgery in ICU.Conclusions: BMI༞20 kg/m2 was a protective factor, while lactic acid༞3 mmol/L after entering ICU and APACHE II score༞20 within 24 h after entering ICU were independent risk factors for the prognosis of sepsis after the gastrointestinal tumor surgery in ICU.

Clinical Features of Systemic Lupus Erythematosus-related Interstitial Lung Disease-a Clinical Retrospective Study

2020 ◽  
Author(s):  
Qian Niu ◽  
Xiaonan Tao
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Pulmonary Function ◽  
Clinical Features ◽  
Clinical Data ◽  
Lupus Erythematosus ◽  
Age Of Onset ◽  
Diagnostic Sensitivity ◽  
Smoking History ◽  
Independent Risk Factors

Abstract Background: There is no conclusion about the correlation between autoantibodies in SLE patients and ILD. In order to help early diagnosis of SLE-ILD, here we will compare the differences in clinical data of SLE-ILD and SLE-NILD patients and explore the clinical features of SLE-ILD and the value of indicators related to the diagnosis of SLE-ILD and independent risk factors. Methods: A clinical retrospective study. Select 89 SLE-ILD patients and 187 SLE-NILD patients, collect all patients' age of onset, smoking history, sex, and autoantibodies, and compare the differences between the two. Additionally collect respiratory manifestations, pulmonary auscultation signs, pulmonary computer tomography and pulmonary function of SLE-ILD patients. Rely on the above clinical data to carry out relevant summary and statistical analysis, and explore the correlation between pulmonary function and autoantibodies in SLE-ILD patients, the value of autoantibodies in the diagnosis of SLE-ILD and the independent risk factors of SLE-ILD. Results：SLE-ILD patients have a higher ANA positive rate than SLE-NILD patients. There is no correlation found between pulmonary function indexes and autoantibodies in SLE-ILD patients. The diagnostic sensitivity of ANA for SLE-ILD is 97.8%, specificity only 3.2%. The diagnostic sensitivity and specificity of Ro-52 are 61.8% and 52.9%. Age, ANA, SM, and Ro-52 are independent risk factors for the onset of SLE-ILD.Conclusions: Age, ANA, SM, and Ro-52 are meaningful and notable indicators for SLE patients when in doubt whether they are accompanied by ILD.

scholarly journals Stepwise lactate kinetics in critically ill patients: prognostic, influencing factors, and clinical phenotype

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Tang ◽  
Longxiang Su ◽  
Dongkai Li ◽  
Ye Wang ◽  
Qianqian Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Glucose ◽  
Sofa Score ◽  
Clinical Phenotype ◽  
Demographic Data ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Clinical Phenotypes ◽  
Lactate Kinetics ◽  
Arterial Blood

Abstract Background To investigate the optimal target e of lactate kinetics at different time during the resuscitation, the factors that influence whether the kinetics achieve the goals, and the clinical implications of different clinical phenotypes. Methods Patients with hyperlactatemia between May 1, 2013 and December 31, 2018 were retrospectively analyzed. Demographic data, basic organ function, hemodynamic parameters at ICU admission (T0) and at 6 h, 12 h, 24 h, 48 h, and 72 h, arterial blood lactate and blood glucose levels, cumulative clinical treatment conditions at different time points and final patient outcomes were collected. Results A total of 3298 patients were enrolled, and the mortality rate was 12.2%. The cutoff values of lactate kinetics for prognosis at 6 h, 12 h, 24 h, 48 h, and 72 h were 21%, 40%, 57%, 66%, and 72%. The APACHE II score, SOFA score, heart rate (HR), and blood glucose were risk factors that correlated with whether the lactate kinetics attained the target goal. Based on the pattens of the lactate kinetics, eight clinical phenotypes were proposed. The odds ratios of death for clinical phenotypes VIII, IV, and II were 4.39, 4.2, and 5.27-fold of those of clinical phenotype I, respectively. Conclusion Stepwise recovery of lactate kinetics is an important resuscitation target for patients with hyperlactatemia. The APACHE II score, SOFA score, HR, and blood glucose were independent risk factors that influenced achievement of lactate kinetic targets. The cinical phenotypes of stepwise lactate kinetics are closely related to the prognosis.

scholarly journals The prognostic factors in sepsis patients after operation of gastrointestinal tumors in ICU

2020 ◽  
Author(s):  
Ren-Xiong Chen ◽  
Zhou-Qiao Wu ◽  
Zi-Yu Li ◽  
Hong-Zhi Wang ◽  
Jia-Fu Ji
Keyword(s):  
Risk Factors ◽  
Lactic Acid ◽  
Prognostic Factors ◽  
Protective Factor ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Tumor Surgery ◽  
Gastrointestinal Tumor ◽  
All Cause Mortality ◽  
Independent Risk Factors

Abstract Objectives: We studied the clinical profiles and the prognostic factors in patients with sepsis after thegastrointestinal tumor surgery in ICU.Methods: We retrospectively screened patients who underwent the gastrointestinal tumor surgery at the Peking University Cancer Hospital from January 2015 to December 2019. Among them, 181 patients who were diagnosed with sepsis in ICU were enrolled in our study. Cox regression was performed for multivariate adjusted factor analyses.Results: The 90-day all-cause mortality rate was 11.1% in our study. The univariate analysis showed that BMI, shock within 48h after entering ICU, number of blood leukocytes, the ratio of lymphocytes to neutrophils, INR, creatinine, procalcitonin, lactic acid, oxygenation index, SOFA score within 24h after entering ICU, APACHE II score within 24h after entering ICU were statistically significant. In multiple analysis, we found that BMI＞20kg/m2 was a protective factor, while lactic acid＞3 mmol/L after entering ICU and APACHE II score＞20 within 24h after entering ICU were independent risk factors for the prognosis of sepsis after the gastrointestinal tumor surgery in ICU. Conclusions: The 90-day all-cause mortality rate was 11.1% in our study. BMI＞20kg/m2 was a protective factor, while lactic acid＞3 mmol/L after entering ICU and APACHE II score＞20 within 24h after entering ICU were independent risk factors for the prognosis of sepsis after the gastrointestinal tumor surgery in ICU.

scholarly journals Stepwise Lactate Kinetics in Critically Ill Patients: Prognostic,Influencing Factors,and Clinical Phenotype

2020 ◽  
Author(s):  
Bo Tang ◽  
Longxiang Su ◽  
Dongkai Li ◽  
Ye Wang ◽  
Qianqian Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Glucose ◽  
Sofa Score ◽  
Clinical Phenotype ◽  
Demographic Data ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Clinical Phenotypes ◽  
Lactate Kinetics ◽  
Arterial Blood

Abstract Purpose: To investigate the optimal target e of lactate kinetics at different time during the resuscitation, the factors that influence whether the kinetics achieve the goals, and the clinical implications of different clinical phenotypes. Methods: Patients with hyperlactatemia between May 1, 2013 and December 31, 2018 were retrospectively analyzed. Demographic data, basic organ function, hemodynamic parameters at ICU admission (T0) and at 6 h, 12 h, 24 h, 48 h, and 72 h, arterial blood lactate and blood glucose levels, cumulative clinical treatment conditions at different time points and final patient outcomes were collected. Results: A total of 3298 patients were enrolled, and the mortality rate was 12.2%. The cutoff values of lactate kinetics for prognosis at 6 h, 12 h, 24 h, 48 h, and 72 h were 21%, 40%, 57%, 66%, and 72%. The APACHE II score, SOFA score, heart rate (HR), and blood glucose were risk factors that influenced whether the lactate kinetics attained the target goal. Based on the pattens of the lactate kinetics, eight clinical phenotypes were proposed. The odds ratios of death for clinical phenotypes VIII, IV, and II were 4.39, 4.2, and 5.27-fold of those of clinical phenotype I, respectively. Conclusion: Stepwise recovery of lactate kinetics is an important resuscitation target for patients with hyperlactatemia. The APACHE II score, SOFA score, HR, and blood glucose were independent risk factors that influenced achievement of lactate kinetic targets. The cinical phenotypes of stepwise lactate kinetics are closely related to the prognosis.

Sign in / Sign up

Export Citation Format

Share Document