scholarly journals A prospective study of prediction of outcomes in perforative peritonitis using apache II scoring system

2017 ◽  
Vol 4 (8) ◽  
pp. 2648
Author(s):  
Rajinder Singh ◽  
Harprit Kaur Madan ◽  
Sandeep H. Tayade
Keyword(s):  
Scoring System ◽  
Death Rate ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Mortality And Morbidity ◽  
Risk Of Mortality ◽  
Perforative Peritonitis ◽  
A Prospective Study

Background: To predict the risk of mortality and morbidity in patients with perforative peritonitis using APACHE II scoring system. To evaluate the usefulness of APACHE II scoring system as a potential clinical and research tool which could be included as routine part of patient assessment in institution like ours.Methods: This was a prospective, observational study of prediction of outcomes in 80 patients of perforative peritonitis using APACHE II scoring system, conducted during the period of 2 years at our tertiary care institute.Results: Predicted death rate of the study was 17.31% and observed death rate was 25%. However, when observed and predicted death rates were compared in group of patients with APACHE II score of <10, it was over estimating the mortality. In group of patients with APACHE II score 11-20 and >20 it was underestimating the mortality. About 71.2% patients came under APACHE II score <10 with mortality of 3.5%. 23.7% came under group of patients with APACHE II score of 11-20 with mortality of 73.6% and only 5% patients had score >20 with 100% mortality were seen amongst them.Conclusions: In the present study, APACHE II scoring system was found to be accurate predictor of group outcome and can be effectively used in prediction of group outcome in similar population, but does not give sufficient confidence for outcome in an individual patient.

scholarly journals The Characteristics of Mortality Predictor Scoring for Sepsis Patients in Haji Adam Malik Hospital

2021 ◽  
Vol 8 (10) ◽  
pp. 339-344
Author(s):  
Abdul Halim Harahap ◽  
Franciscus Ginting ◽  
Lenni Evalena Sihotang
Keyword(s):  
Sofa Score ◽  
Scoring System ◽  
Scoring Systems ◽  
Developed Countries ◽  
Apache Ii ◽  
Apache Ii Score ◽  
P Value ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
Score Apache

Introduction: Sepsis is a leading cause of death in the Intensive Care Unit (ICU) in developed countries and its incidence is increasing. Many scoring systems are used to assess the severity of disease in patients admitted to the ICU. SOFA score to assess the degree of organ dysfunction in septic patients. The Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system is most often used for patients admitted to the ICU. CCI scoring system to assess the effect of comorbid disease in critically ill patients on mortality. The study aimed to describe the characteristics of the use of scoring to predict patients’ mortality admitted to Haji Adam Malik Hospital. Methods: This is an observational study with a cross-sectional design. A total of 299 study subjects met the inclusion criteria and exclusion criteria, three types of scoring, namely SOFA score, APACHE II score, and CCI score were used to assess the prognosis of septic patients. Data analysis was performed using SPSS. P-value <0.05 was considered statistically significant. Results: A total of 252 people (84.3%) of sepsis patients died. The mean age of the septic patients who died was 54.25 years. The SOFA score ranged from 0-24, the median SOFA score in deceased sepsis patients was 5.0. The APACHE II score ranged from 0-71, the median APACHE II score in deceased sepsis patients was 23.0. The CCI score ranged from 0-37, the median CCI score in deceased sepsis patients was 5.0. Conclusion: Higher scores are associated with an increased probability of death in septic patients. Keywords: Sepsis; mortality predictor; SOFA score; APACHE II score, CCI score.

scholarly journals CORRELATION BETWEEN LEVEL OF SOLUBLE FAS AND DEGREE OF SEPSIS SEVERITY BASED ON APACHE II SCORE

2018 ◽  
Vol 24 (3) ◽  
pp. 231
Author(s):  
Pauline Hadisiswoyo ◽  
Endang Retnowati ◽  
Erwin Astha Triyono
Keyword(s):  
Prediction Model ◽  
Scoring System ◽  
Linear Regression Analysis ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Sepsis Severity ◽  
Cross Sectional ◽  
Chronic Health ◽  
Soluble Fas ◽  
Positive Correlations

A widely used scoring system to assess the severity of sepsis is Acute Physiology, Age, and Chronic Health Evaluation (APACHE) II scoring system, however there are some disadvantages in using this. Other parameters are needed to predict severity and outcome of sepsis. Proinflammatory cytokines and Fas receptors are increased in sepsis and their concentration elevations are correlated with disease severity. An increase of soluble Fas level will follow increasing Fas receptors. This study aimed to prove any correlation between the level of soluble Fas and degree of sepsis severity based on APACHE II score. A cross-sectional observational study was conducted in January-June 2015 on 30 septic patients. APACHE II scores were calculated from the patients’physiological data, age, and chronic health problem status. Levels of soluble Fas were measured using the ELISA method (Human FAS/ CD95 (Factor-Related Apoptosis) ELISA Kit, Elabscience Biotechnology). Levels of soluble Fas ranged between 1,049-2,783 pg/mL (1,855.7 ± 477.27 pg/mL). APACHE II scores varied between 4-29 (17.2 ± 5.82). Significant positive correlations between levels of soluble Fas and APACHE II score (r=0.347, p=0.03) were found. A prediction model of soluble Fas levels based on APACHE II score was made. Linear regression analysis produced a prediction model of soluble Fas levels based on APACHE II score, in which soluble Fas level= 1,365.8 + 28.485 x APACHE II score.  

scholarly journals Conservative management of single foetal death in multiple pregnancy at a tertiary care hospital in Bangladesh: Two case reports

2017 ◽  
Vol 45 (3) ◽  
pp. 172-174
Author(s):  
Eva Rani Nandi ◽  
Fatema Ashraf ◽  
Nilofar Yasmin ◽  
Hasina Begum
Keyword(s):  
Case Reports ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Care Hospital ◽  
Foetal Death ◽  
Mortality And Morbidity ◽  
Risk Of Mortality ◽  
Proper Diagnosis ◽  
Management Challenge

The single fetal death in multiple pregnancy is not rare. Death of one fetus in multiple pregnancy increases the risk of mortality and morbidity of the surviving fetus. This might pose management challenge to the obstetrician. It is a cause of great concern and psychological stress to the parents. Proper diagnosis and intervention in appropriate time can improve the maternal and neonatal outcome. Adequate counseling, psychological support and close follow up are mandatory. There are potential complications to the mother and the surviving twin.Bangladesh Med J. 2016 Sep; 45 (3): 172-174

scholarly journals A PROSPECTIVE OBSERVATIONAL STUDY ON PREVALENCE OF HYPOTHYROIDISM IN A TERTIARY CARE TEACHING HOSPITAL

2018 ◽  
Vol 10 (6) ◽  
pp. 23
Author(s):  
N. Swathi ◽  
Voleti Vijaya Kumar ◽  
M. Farjana ◽  
M. Vishnu Vardhan ◽  
M. Munendra ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Tertiary Care ◽  
Age Group ◽  
Medical College ◽  
Study Population ◽  
Age Limit ◽  
N 93 ◽  
A Prospective Study ◽  
Group Distribution ◽  
Positive Results

Objective: To determine the prevalence of hypothyroidism in a rural population of Nandyal.Methods: A prospective study was conducted in Santhiram medical college and general hospital, Nandyal from July 2017 to December 2017, to study the prevalence of hypothyroidism among the population. Results: In this study, 1000 patients were evaluated for the thyroid functioning, among them n=104(10.4%) showing positive results in hypothyroidism. The positive 104 patients showed that n=63 (60.57%) of the population are in the age limit of 21-40. Out of the same population are n=11 (10.6%) are male and female are n=93 (89.43%). In age group distribution more prevalence was observed in 21-30 y of age group n=36 (34.61%). In this study, sub-clinical hypothyroidism was prevalent in females n=80 (76.92%) than males n=10 (9.61%).Conclusion: Our study demonstrates that hypothyroidism was higher in a female with age group as 21-40 y and there is a significant prevalence of hypothyroidism in the study population.

scholarly journals C-reactive protein concentration as a risk predictor of mortality in intensive care unit: a multicenter, prospective, observational study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rong Qu ◽  
Linhui Hu ◽  
Yun Ling ◽  
Yating Hou ◽  
Heng Fang ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Inflammatory Markers ◽  
Prospective Observational Study ◽  
Apache Ii ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Icu Mortality ◽  
Reactive Protein ◽  
Risk Reclassification ◽  
Multicenter Prospective Observational Study

Abstract Background It is not clear whether there are valuable inflammatory markers for prognosis judgment in the intensive care unit (ICU). We therefore conducted a multicenter, prospective, observational study to evaluate the prognostic role of inflammatory markers. Methods The clinical and laboratory data of patients at admission, including C-reactive protein (CRP), were collected in four general ICUs from September 1, 2018, to August 1, 2019. Multivariate logistic regression was used to identify factors independently associated with nonsurvival. The area under the receiver operating characteristic curve (AUC-ROC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to evaluate the effect size of different factors in predicting mortality during ICU stay. 3 -knots were used to assess whether alternative cut points for these biomarkers were more appropriate. Results A total of 813 patients were recruited, among whom 121 patients (14.88%) died during the ICU stay. The AUC-ROC values of PCT and CRP for discriminating ICU mortality were 0.696 (95% confidence interval [CI], 0.650–0.743) and 0.684 (95% CI, 0.633–0.735), respectively. In the multivariable analysis, only APACHE II score (odds ratio, 1.166; 95% CI, 1.129–1.203; P = 0.000) and CRP concentration > 62.8 mg/L (odds ratio, 2.145; 95% CI, 1.343–3.427; P = 0.001), were significantly associated with an increased risk of ICU mortality. Moreover, the combination of APACHE II score and CRP > 62.8 mg/L significantly improved risk reclassification over the APACHE II score alone, with NRI (0.556) and IDI (0.013). Restricted cubic spline analysis confirmed that CRP concentration > 62.8 mg/L was the optimal cut-off value for differentiating between surviving and nonsurviving patients. Conclusion CRP markedly improved risk reclassification for prognosis prediction.

scholarly journals A prospective study of single dose preoperative antibiotic cover in clean elective surgical cases- a single center study

2020 ◽  
Vol 8 (1) ◽  
pp. 165
Author(s):  
Siddhartha Gowthaman Subramaniyan ◽  
Prabhu Gunasekaran ◽  
Ramanathan Manickam
Keyword(s):  
Single Dose ◽  
Prospective Observational Study ◽  
Bacterial Flora ◽  
Cost Effective ◽  
Skin Incision ◽  
Klebsiella Pneumonia ◽  
Age Group ◽  
Mortality And Morbidity ◽  
Single Center Study ◽  
A Prospective Study

Background: Surgical site infection (SSI) is the third most common nosocomial infections occurring worldwide, thus leading to increasing cost, mortality and morbidity. The main objective was to know the incidence of SSI in clean surgical procedures carried out in the institute of MGMCRI and to determine various pathogens causing SSI.Methods: This was a prospective observational study done on 100 patients in Department of General Surgery in MGMCRI, Puducherry from June 2015 to August 2017 who underwent clean surgical procedure. Preoperatively single done of injection cefazolin 1gm intravenous preparation was given 30 minus before the skin incision and patient were observed and followed up meticulously for the incidence of SSI and to determine the bacterial flora in the event of SSI.Results: In our study a total of 100 patients were included.  In our study a total of three out of 100 patients developed SSI which was around 3%.Out of the 3 patients who had SSI all were a male which is around 4.6% in our study. In relation to the distribution based on the age group more than 50 year of the age are most frequently associated with SSI in our study. The bacterial flora includes staphylococcus aureus which was isolated from one patient and Klebsiella pneumonia isolated from two patients who had surgical site infections.Conclusions: This study concludes that single dose pre-operative antibiotic has advantage in prevention of SSI and it is cost effective for patient. 

scholarly journals Utilisation of antimicrobial agents in intensive care unit at a tertiary care teaching hospital in eastern India

2019 ◽  
Vol 8 (9) ◽  
pp. 1951
Author(s):  
Rajendra Kumar Panda ◽  
P. Ansuman Abhisek ◽  
Lalit Mohan Sika ◽  
Shweta Supriya Pradhan ◽  
Sidharth Srabana Routray ◽  
...  
Keyword(s):  
Intensive Care ◽  
Antimicrobial Agents ◽  
Multinomial Logistic Regression ◽  
Tertiary Care ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Defined Daily Dose ◽  
Female Ratio ◽  
Utilisation Pattern ◽  
Bed Days

Background: Antimicrobial agents (AMAs) are the most frequently used drugs in the intensive care units (ICU) and regular auditing can prevent the development of resistance to AMAs, reduce the cost and incidence of adverse drug reactions. The present study was conducted to assess the drug utilisation pattern by measuring the defined daily dose (DDD) per 100 bed days for the AMAs used and their correlation with the APACHE score II.Methods: This was a prospective observational study, conducted in the Central ICU of SCB Medical College and Hospital, Cuttack, Odisha for 4 months. Data regarding demographic profile, diagnosis, APACHE II score, microbiologic investigation, length of stay, outcome and utilisation pattern of AMAs assessing anatomic therapeutic chemical (ATC) classification and measuring the antimicrobial consumption index (ACI) equal to DDD per 100 bed days were collected and subjected to descriptive analysis. Multinomial logistic regression model was used to predict probabilities of different possible outcomes of categorically distributed variables and independent variables.Results: Mean age of study population was 44.70±14.814 with male and female ratio of 1.63:1. Septicaemia was the most common cause of admission. AMAs were prescribed to 92.66% of patients during their stay which constitutes 37.32% of the total drugs used. The DDD per 100 bed days for the AMAs were 118.59 and ceftriaxone was found to be most frequently used. Patients having higher APACHE II score received more no of AMAs (4.20±1.30). Patients having low APACHE II Scores received less number of antibiotics as compared to patients having higher score.Conclusions: AMAs were prescribed to 92.66% patients in the central ICU and there is significant relation between the APACHE II score and number of AMAs prescribed.

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