scholarly journals Weaning Pattern Characteristics, Based on Simplified Acute Physiology Score 3, of Critically Ill Patients Requiring Ventilator Care

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Jong Cook Park
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Simplified Acute Physiology Score ◽  
Acute Physiology Score ◽  
Ventilator Care

scholarly journals Nephrotoxic drug burden among 1001 critically ill patients: impact on acute kidney injury

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Stephan Ehrmann ◽  
◽  
Julie Helms ◽  
Aurélie Joret ◽  
Laurent Martin-Lefevre ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Drug Prescription ◽  
Kidney Injury ◽  
Simplified Acute Physiology Score ◽  
Severity Of Disease ◽  
Lower Severity

Abstract Background Nephrotoxic drug prescription may contribute to acute kidney injury (AKI) occurrence and worsening among critically ill patients and thus to associated morbidity and mortality. The objectives of this study were to describe nephrotoxic drug prescription in a large intensive-care unit cohort and, through a case–control study nested in the prospective cohort, to evaluate the link of nephrotoxic prescription burden with AKI. Results Six hundred and seventeen patients (62%) received at least one nephrotoxic drug, among which 303 (30%) received two or more. AKI was observed in 609 patients (61%). A total of 351 patients were considered as cases developing or worsening AKI a given index day during the first week in the intensive-care unit. Three hundred and twenty-seven pairs of cases and controls (patients not developing or worsening AKI during the first week in the intensive-care unit, alive the case index day) matched on age, chronic kidney disease, and simplified acute physiology score 2 were analyzed. The nephrotoxic burden prior to the index day was measured in drug.days: each drug and each day of therapy increasing the burden by 1 drug.day. This represents a semi-quantitative evaluation of drug exposure, potentially easy to implement by clinicians. Nephrotoxic burden was significantly higher among cases than controls: odds ratio 1.20 and 95% confidence interval 1.04–1.38. Sensitivity analysis showed that this association between nephrotoxic drug prescription in the intensive-care unit and AKI was predominant among the patients with lower severity of disease (simplified acute physiology score 2 below 48). Conclusions The frequently observed prescription of nephrotoxic drugs to critically ill patients may be evaluated semi-quantitatively through computing drug.day nephrotoxic burden, an index significantly associated with subsequent AKI occurrence, and worsening among patients with lower severity of disease.

Mid-regional pro-adrenomedullin predicts poor outcome in non-selected patients admitted to an intensive care unit

2019 ◽  
Vol 57 (4) ◽  
pp. 549-555 ◽  
Author(s):  
Chiara Bellia ◽  
Luisa Agnello ◽  
Bruna Lo Sasso ◽  
Giulia Bivona ◽  
Maurizio Santi Raineri ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Simplified Acute Physiology Score ◽  
Icu Admission ◽  
Open Issue ◽  
The One

Abstract Background Mortality risk and outcome in critically ill patients can be predicted by scoring systems, such as APACHE and SAPS. The identification of prognostic biomarkers, simple to measure upon admission to an intensive care unit (ICU) is an open issue. The aim of this observational study was to assess the prognostic value of plasma mid-regional pro-adrenomedullin (MR-proADM) at ICU admission in non-selected patients in comparison to Acute Physiology and Chronic Health Evaluation II (APACHEII) and Simplified Acute Physiology Score II (SAPSII) scores. Methods APACHEII and SAPSII scores were calculated after 24 h from ICU admission. Plasma MR-proADM levels were measured by TRACE-Kryptor on admission (T0) and after 24 h (T24). The primary endpoint was intra-hospital mortality; secondary endpoint was length of stay (LOS). Results One hundred and twenty-six consecutive non-selected patients admitted to an ICU were enrolled. Plasma MR-proADM levels were correlated with LOS (r=0.28; p=0.0014 at T0; r=0.26; p=0.005 at T24). Multivariate analysis showed that T0 MR-proADM was a significant predictor of mortality (odds ratio [OR]: 1.27; 95% confidence interval [95%CI]: 1.03–1.55; p=0.022). Receiver operating characteristic curves analysis revealed that MR-proADM on ICU admission identified non-survivors with high accuracy, not inferior to the one of APACHEII and SAPSII scores (area under the curve [AUC]: 0.71; 95%CI: 0.62–0.78; p=0.0002 for MR-proADM; AUC: 0.71; 95%CI: 0.62–0.79; p<0.0001 for APACHEII; AUC: 0.8; 95%CI: 0.71–0.87; p<0.0001 for SAPSII). Conclusions Our findings point out a role of MR-proADM as a prognostic tool in non-selected patients in ICUs being a reliable predictor of mortality and LOS and support its use on admission to an ICU to help the management of critically ill patients.

Evaluation of the simplified acute physiology score (SAPS-OB) in critically ill obstetric patients

2017 ◽  
Vol 37 (6) ◽  
pp. 799-800
Author(s):  
Sofiene Ben Marzouk ◽  
Maha Touaibia ◽  
Amel Achour-Jenayah ◽  
Laidi Bennasr ◽  
Arbia Shili ◽  
...  
Keyword(s):  
Critically Ill ◽  
Simplified Acute Physiology Score ◽  
Acute Physiology Score

scholarly journals Blood Urea Nitrogen to Serum Albumin Ratio Independently Predicts Mortality in Critically Ill Patients With Acute Pulmonary Embolism

2021 ◽  
Vol 27 ◽  
pp. 107602962110102
Author(s):  
Jihong Fang ◽  
Bin Xu
Keyword(s):  
Pulmonary Embolism ◽  
Serum Albumin ◽  
Critically Ill ◽  
Blood Urea Nitrogen ◽  
Critically Ill Patients ◽  
Acute Pulmonary Embolism ◽  
Acute Physiology Score ◽  
Icu Mortality ◽  
Urea Nitrogen ◽  
Icu Admission

Acute pulmonary embolism (APE) is one of the prominent causes of death in patients with cardiovascular disease. Currently, reliable biomarkers to predict the prognosis of patients with APE are limited. The present study aimed to investigate the association of blood urea nitrogen to serum albumin (B/A) ratio and intensive care unit (ICU) mortality in critically ill patients with APE. A retrospective cohort study was performed using data extracted from a freely accessible critical care database (MIMIC-III). Adult (≥18 years) patients of first ICU admission with a primary diagnosis of APE in the database were enrolled in the study. The primary endpoint was the ICU mortality rate while the 28-day mortality after ICU admission was the secondary endpoint. The data of survivors and non-survivors were compared. A total of 1048 patients with APE were enrolled in this study, of which 131 patients died in ICU and 169 patients died within 28 days after ICU admission. The B/A ratio in the non-survivors group was significantly higher compared to the survivors group ( P < 0.001). The multivariate analysis revealed that the B/A ratio was an independent predictor of ICU mortality (odds ratio [OR] 1.10, 95% CI 1.07-1.14, P < 0.001) and all-cause mortality within 28 days after ICU admission (hazard ratio [HR] 1.07, 95% CI 1.05-1.09, P < 0.001) in APE patients. The B/A ratio showed a greater area under the curve (AUC) of ICU mortality prediction (0.80; P < 0.001) than simplified acute physiology score II (SAPSII) (0.79), systemic inflammatory response syndrome score (SIRS) (0.62), acute physiology score III (APSIII) (0.76) and sequential organ failure assessment (SOFA) score (0.71). The B/A ratio could be a simple and useful prognostic tool to predict mortality in critically ill patients with APE.

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