scholarly journals Combination of dirty mass volume and APACHE II score predicts mortality in patients with colorectal perforation

2021 ◽  
Author(s):  
Daichi Ishikawa ◽  
Yukako Takehara ◽  
Atsushi Takata ◽  
Kazuhito Takamura ◽  
Hirohiko Sato
Keyword(s):  
Multivariate Analysis ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Postoperative Mortality ◽  
Apache Ii ◽  
Prognostic Indicators ◽  
Apache Ii Score ◽  
Colorectal Perforation ◽  
Roc Curve Analysis ◽  
Mass Volume

Abstract Background: “Dirty mass” is a specific computed tomography (CT) finding that is seen frequently in colorectal perforation. The prognostic significance of this finding for mortality is unclear.Methods: Fifty-eight consecutive patients with colorectal perforation who underwent emergency surgery were retrospectively reviewed in the study. Dirty mass identified on multi-detector row CT (MDCT) was 3D-reconstructed and its volume was calculated using Ziostation software. Dirty mass volume and other clinical characteristics were compared between survivor (n = 45) and mortality groups (n = 13) to identify predictive factors for mortality. Mann–Whitney U test and Χ2 test were used in univariate analysis and logistic regression analysis was used in multivariate analysis.Results: Dirty mass was identified in 36/58 patients (62.1%) and located next to perforated colorectum in all cases. Receiver-operating characteristic (ROC) curve analysis identified the highest peak at 96.3 cm3, with sensitivity of 0.643 and specificity of 0.864. Univariate analysis revealed dirty mass volume, acute disseminated intravascular coagulation (DIC) score, acute physiology and chronic health evaluation II (APACHE II) score, and sequential organ failure assessment (SOFA) score as prognostic markers for mortality (p<0.01). Multivariate analysis revealed dirty mass volume and APACHE II score as independent prognostic indicators for mortality. Mortality was stratified by dividing patients into four groups according to dirty mass volume and APACHE II score. Conclusions: The combination of dirty mass volume and APACHE II score could stratify the postoperative mortality risk in patients with colorectal perforation. According to the risk stratification, surgeons might be able to decide the surgical procedures and intensity of postoperative management.

scholarly journals Combination of dirty mass volume and APACHE II score predicts mortality in patients with colorectal perforation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Daichi Ishikawa ◽  
Yukako Takehara ◽  
Atsushi Takata ◽  
Kazuhito Takamura ◽  
Hirohiko Sato
Keyword(s):  
Multivariate Analysis ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Postoperative Mortality ◽  
Apache Ii ◽  
Prognostic Indicators ◽  
Apache Ii Score ◽  
Colorectal Perforation ◽  
Roc Curve Analysis ◽  
Mass Volume

Abstract Background “Dirty mass” is a specific computed tomography (CT) finding that is seen frequently in colorectal perforation. The prognostic significance of this finding for mortality is unclear. Methods Fifty-eight consecutive patients with colorectal perforation who underwent emergency surgery were retrospectively reviewed in the study. Dirty mass identified on multi-detector row CT (MDCT) was 3D-reconstructed and its volume was calculated using Ziostation software. Dirty mass volume and other clinical characteristics were compared between survivor (n = 45) and mortality groups (n = 13) to identify predictive factors for mortality. Mann–Whitney U test and Χ2 test were used in univariate analysis and logistic regression analysis was used in multivariate analysis. Results Dirty mass was identified in 36/58 patients (62.1%) and located next to perforated colorectum in all cases. Receiver-operating characteristic (ROC) curve analysis identified the highest peak at 96.3 cm3, with sensitivity of 0.643 and specificity of 0.864. Univariate analysis revealed dirty mass volume, acute disseminated intravascular coagulation (DIC) score, acute physiology and chronic health evaluation II (APACHE II) score, and sequential organ failure assessment (SOFA) score as prognostic markers for mortality (p<0.01). Multivariate analysis revealed dirty mass volume and APACHE II score as independent prognostic indicators for mortality. Mortality was stratified by dividing patients into four groups according to dirty mass volume and APACHE II score. Conclusions The combination of dirty mass volume and APACHE II score could stratify the postoperative mortality risk in patients with colorectal perforation. According to the risk stratification, surgeons might be able to decide the surgical procedures and intensity of postoperative management.

scholarly journals Combination of Dirty Mass Volume and APACHE II Score Predicts Mortality in Patients with Colorectal perforation

2020 ◽  
Author(s):  
Daichi Ishikawa ◽  
Yukako Takehara ◽  
Atsushi Takata ◽  
Kazuhito Takamura ◽  
Hirohiko Sato
Keyword(s):  
Multivariate Analysis ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Postoperative Mortality ◽  
Apache Ii ◽  
Prognostic Indicators ◽  
Apache Ii Score ◽  
Colorectal Perforation ◽  
Roc Curve Analysis ◽  
Mass Volume

Abstract Background: “Dirty mass” is a specific computed tomography (CT) finding that is seen frequently in colorectal perforation. The prognostic significance of this finding for mortality is unclear. Methods: Fifty-eight consecutive patients with colorectal perforation who underwent emergency surgery were included in the study. Dirty mass identified on multi-detector row CT (MDCT) was 3D-reconstructed and its volume was calculated using Ziostation software. Dirty mass volume and other clinical characteristics were compared between survivor (n = 45) and mortality groups (n = 13) to identify predictive factors for mortality. Mann–Whitney U test and Χ2 test were used in univariate analysis and logistic regression analysis was used in multivariate analysis. Results: Dirty mass was identified in 36/58 patients (62.1%) and located next to perforated colorectum in all cases. Receiver-operating characteristic (ROC) curve analysis identified the highest peak at 96.3 cm3, with sensitivity of 0.643 and specificity of 0.864. Univariate analysis revealed dirty mass volume, acute disseminated intravascular coagulation (DIC) score, acute physiology and chronic health evaluation II (APACHE II) score, and sequential organ failure assessment (SOFA) score as prognostic markers for mortality (p<0.01). Multivariate analysis revealed dirty mass volume and APACHE II score as independent prognostic indicators for mortality. Mortality was stratified by dividing patients into four groups according to dirty mass volume and APACHE II score. Conclusions: The combination of dirty mass volume and APACHE II score could stratify the postoperative mortality risk in patients with colorectal perforation. According to the risk stratification, surgeons might be able to decide the surgical procedures and intensity of postoperative management.

Survival and Predictors of Outcome in Acute Leukemia Patients Admitted to the Intensive Care Unit.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2778-2778
Author(s):  
Snehal G. Thakkar ◽  
Zachariah A. McIver ◽  
Sanjay R. Mohan ◽  
Giridharan Ramsingh ◽  
Anjali S. Advani ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Intensive Care ◽  
Acute Leukemia ◽  
Hospital Discharge ◽  
Univariate Analysis ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Predictors Of Outcome ◽  
Hemodynamic Support ◽  
The Mean

Abstract Background: Patients with acute leukemia fare poorly when admitted to intensive care units (ICUs). Predictors of outcome and rates of successful discharge have not been defined in the United States. Methods: This is a retrospective analysis of 78 acute leukemia patients admitted to the medical ICU from 2001–2004. Patients were identified by ICD-9 codes and a sudden increase in daily hospital charges (indicating a direct ICU admission or transfer to the ICU from a medical floor). The primary endpoints were improvement and subsequent ICU discharge with continued aggressive leukemia management and survival to 2 months following hospital discharge. Secondary endpoints included 6 and 12 month survival. Univariate and multivariate logistic regression analyses were performed to identify factors predicting outcome. Results: Sixty-five patients were diagnosed with AML and 13 with ALL. Seven patients had good-risk cytogenetics, 32 intermediate, 30 poor and 9 unknown, as defined by CALGB 8461. Fever or infection (37.2%) was the leading cause of hospital admission. The mean age was 53 years, 85% were Caucasian and 51% were female. The median white blood cell (WBC) count was 6.9K. On average, patients were transferred to the ICU on hospital day 13. Of the 69 patients who received chemotherapy, 29 (42%) were in the induction phase and 40 (58%) in the consolidation or relapsed/refractory phase, with a mean chemotherapy day of 15. The most common reason for transfer to the ICU was respiratory compromise (68%) with sepsis (56%) second. Most patients transferred to the ICU had either 1 (47%) or 2 (45%) reasons for transfer. While in the ICU 57 patients required mechanical ventilation with 21 eventually extubated (19 improved; 2 withdrew care). Hemodynamic support (pressors) was used in 41 patients. The mean length of stay in the ICU was 7 days. The mean APACHE II score was 23 ± 7, predicting a mortality of 40%. Overall, 22 patients (28%) improved and 49 (63%) died in the ICU. Seven patients (9%) died after transfer out of the ICU. Two month survival following hospital discharge was 21%. At 6 and 12 months, 13% and 12% were alive, respectively. In univariate analysis, patients with lower APACHE II scores were more likely to improve in the ICU (p=0.002) and to live 2 months post-discharge (p=0.004) than those with higher scores; these findings remained significant in multivariate analysis. In univariate analysis, patients requiring hemodynamic support had lower 6 and 12 month survival than patients not requiring support (p=0.017 and 0.025); these findings remained significant in multivariate analysis (p=0.007 and 0.013). Multivariate analysis also showed that patients with poor risk cytogenetics had lower 6 and 12 month survival than patients with good or intermediate risk cytogenetics (p=0.026 and 0.05). Neither age, WBC, or treatment phase predicted outcome. Conclusion: Higher APACHE II score, use of pressors and adverse cytogenetics predicted for worse outcome. Increased age and presenting WBC did not. One out of five patients survived an ICU admission to be discharged from the hospital. Aggressive medical management is appropriate for patients with acute leukemia and should not be withheld even in patients with advanced age.

scholarly journals Dysphagia and Mechanical Ventilation in Sars-Cov-2 Pneumonia: It’s Real

2021 ◽  
Author(s):  
Mª Luisa Bordeje Laguna ◽  
Pilar Marcos-Neira ◽  
Itziar Martínez de Lagrán Zurbano ◽  
Esther Mor Marco ◽  
Carlos Pollan Guisasola ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Multivariate Analysis ◽  
Predictive Model ◽  
Prone Position ◽  
Respiratory Infection ◽  
Descriptive Analysis ◽  
Univariate Analysis ◽  
Apache Ii ◽  
Apache Ii Score

Abstract BACKGROUND. Severe SARS-CoV-2 pneumonia has brought intensive care units (ICUs) and the consequences of prolonged hospitalisation, such as dysphagia, into focus.METHODS. Study population: Patients with severe pneumonia due to SARS-CoV-2 who required admission to critical units from March to June 2020. Dysphagia diagnostic method: Modified Viscosity Volume Swallowing Test (mV-VST). Objectives. To identify risk factors for dysphagia in patients with severe SARS-CoV-2 pneumonia requiring invasive mechanical ventilation and determine their incidence. Statistical analysis: Descriptive analysis of means or medians according to the normality of quantitative variables and proportions for the descriptive variables (95% CI). Univariate analysis of dysphagia using simple logistic regression. Multivariate analysis and construction of a predictive model for dysphagia using logistic regression.RESULTS. Descriptive analysis. Sample size: 232 patients; 72% (167) required intubation. Of these, 65.9% (110) survived and 84.5% (93) underwent the mV-VST, which diagnosed 26.9% (25) with dysphagia. Age: 60.5 years (95% CI: 58.5 to 61.9). Men: 74.1% (95% CI: 68.1 to 79.4). APACHE II score: 17.7 (95% CI: 13.3 to 23.2). Mechanical ventilation: 14 days (95% CI: 11 to 16); prone position: 79% (95% CI: 72.1 to 84.6); respiratory infection: 34.5% (95% CI: 28.6 to 40.9). Renal failure: 38.5% (95% CI: 30 to 50). Overall mortality: 25.9% (95% CI: 20.6 to 31.9). Mortality in intubated patients: 34.1% (95% CI: 27.3 to 41.7). No patient diagnosed with dysphagia died. Univariate analysis. APACHE II, prone position, days of mechanical ventilation and need for tracheostomy, respiratory infection, kidney failure developed during admission and length of ICU and hospital stay were significantly associated (p<0.05) with dysphagia. Multivariate analysis. Dysphagia is independently explained by APACHE II score (OR: 1.1; 95% CI: 1.01 to 1.3; p=0.04) and tracheostomy (OR: 10.2; 95% CI: 3.2 to 32.1; p<0.001). The resulting predictive model predicts dysphagia with a good ROC curve (AUC: 0.8; 95% CI: 0.7 to 0.9)CONCLUSIONS. Dysphagia affects almost one-third of patients, and the risk of developing dysphagia increases with prolonged mechanical ventilation, tracheostomy and greater severity on admission (APACHE II score).

scholarly journals Endocan Levels in Peripheral Blood Predict Outcomes of Acute Respiratory Distress Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Ling Tang ◽  
Ying Zhao ◽  
Daoxin Wang ◽  
Wang Deng ◽  
Changyi Li ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Characteristic Curve ◽  
White Blood Cells ◽  
Prognostic Significance ◽  
Cox Proportional Hazards ◽  
Clinical Severity ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Roc Curve Analysis ◽  
Severity Scores

Purpose.To investigate the prognostic significance of endocan, compared with procalcitonin (PCT), C-reactive protein (CRP),white blood cells (WBC), neutrophils (N), and clinical severity scores in patients with ARDS.Methods.A total of 42 patients with ARDS were initially enrolled, and there were 20 nonsurvivors and 22 survivors based on hospital mortality. Plasma levels of biomarkers were measured and the acute physiology and chronic health evaluation II (APACHE II) was calculated on day 1 after the patient met the defining criteria of ARDS.Results.Endocan levels significantly correlated with the APACHE II score in the ARDS group (r=0.676,P=0.000,n=42). Of 42 individuals with ARDS, 20 were dead, and endocan was significantly higher in nonsurvivors than in survivors (median (IQR) 5.01 (2.98–8.44) versus 3.01 (2.36–4.36) ng/mL,P=0.017). According to the results of the ROC-curve analysis and COX proportional hazards models, endocan can predict mortality of ARDS independently with a hazard ratio of 1.374 (95% CI, 1.150–1.641) and an area of receiver operator characteristic curve (AUROC) of 0.715 (P=0.017). Moreover, endocan can predict the multiple-organ dysfunction of ARDS.Conclusion.Endocan is a promising biomarker to predict the disease severity and mortality in patients with ARDS.

scholarly journals Serum Soluble Triggering Receptor Expressed on Myeloid Cells-1 and Procalcitonin Can Reflect Sepsis Severity and Predict Prognosis: A Prospective Cohort Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Zhenyu Li ◽  
Hongxia Wang ◽  
Jian Liu ◽  
Bing Chen ◽  
Guangping Li
Keyword(s):  
Sofa Score ◽  
Prognostic Significance ◽  
Elevated Serum ◽  
Myeloid Cells ◽  
Serum Levels ◽  
Clinical Severity ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Survival Group ◽  
Severity Scores

Objective. To investigate the prognostic significance of serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), procalcitonin (PCT), N-terminal probrain natriuretic peptide (NT-pro-BNP), C-reactive protein (CRP), cytokines, and clinical severity scores in patients with sepsis.Methods. A total of 102 patients with sepsis were divided into survival group (n=60) and nonsurvival group (n=42) based on 28-day mortality. Serum levels of biomarkers and cytokines were measured on days 1, 3, and 5 after admission to an ICU, meanwhile the acute physiology and chronic health evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores were calculated.Results. Serum sTREM-1, PCT, and IL-6 levels of patients in the nonsurvival group were significantly higher than those in the survival group on day 1 (P<0.01). The area under a ROC curve for the prediction of 28 day mortality was 0.792 for PCT, 0.856 for sTREM-1, 0.953 for SOFA score, and 0.923 for APACHE II score. Multivariate logistic analysis showed that serum baseline sTREM-1 PCT levels and SOFA score were the independent predictors of 28-day mortality. Serum PCT, sTREM-1, and IL-6 levels showed a decrease trend over time in the survival group (P<0.05). Serum NT-pro-BNP levels showed the predictive utility from days 3 and 5 (P<0.05).Conclusion. In summary, elevated serum sTREM-1 and PCT levels provide superior prognostic accuracy to other biomarkers. Combination of serum sTREM-1 and PCT levels and SOFA score can offer the best powerful prognostic utility for sepsis mortality.

scholarly journals Clinicopathological Characteristics and Prognostic Factors in Axial Chondroblastomas: A Retrospective Analysis of 61 Cases and Comparison with Extra-Axial Chondroblastomas

2022 ◽  
Author(s):  
Bo-Wen Zheng ◽  
Bo-Yv Zheng ◽  
Hua-Qing Niu ◽  
Xiao-Bin Wang ◽  
Guo-Hua Lv ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Clinicopathological Characteristics ◽  
Motor Dysfunction ◽  
Surrounding Tissue ◽  
Wide Resection ◽  
Tissue Specimens

Abstract Background The clinical characteristics and prognostic factors of axial chondroblastoma (ACB) are still poorly understood. Purpose To characterize clinicopathological characteristics in a large ACB cohort and investigate their correlation with survival. We also sought to compare these results with extra-axial CB (EACB). Methods Our institution's local database was retrospectively reviewed and included a total of 132 CB patients, including 61 ACB patients and 71 EACB patients. Immunohistochemistry was used to assess the expression levels of Vimentin (Vim), S100, and cytokeratin (CK) on tumor cells in 132 tissue specimens. Results Overall, ACB and EACB had similar characteristics, except for older age and tumor size, as well as higher Vim expression, incidence of surrounding tissue invasion and postoperative sensory or motor dysfunction. Whereas wide resection and absence of invasion of surrounding tissues were consistently associated with favorable survival in the ACB and EACB cohorts in univariate analysis, most parameters showed differential prognostic significance between the 2 groups. Significant prognostic factors for local recurrence-free survival in multivariate analysis included the type of resection and chicken-wire calcification in the ACB cohort. Multivariate analysis of overall survival demonstrated that the type of resection was a significant predictor in the ACB cohort, whereas the type of resection and postoperative sensory or motor dysfunction were predictive of overall survival in the EACB group. Conclusion These data suggest that there may be distinct biological behaviors between ACB and EACB and may provide useful information to better understand the prognostic characteristics of patients with ACB and to improve outcome prediction in patients with ACB.

scholarly journals Prognostic significance of the combination of preoperative red cell distribution width and platelet distribution width in patients with gastric cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroaki Saito ◽  
Shota Shimizu ◽  
Yuji Shishido ◽  
Kozo Miyatani ◽  
Tomoyuki Matsunaga ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Prognostic Significance ◽  
Prognostic Indicators ◽  
Red Cell ◽  
Cell Distribution ◽  
Disease Specific Survival ◽  
Platelet Distribution Width ◽  
Distribution Width ◽  
Disease Specific

Abstract Background Platelet distribution width (PDW) and red cell distribution width (RDW) are readily obtainable data, and are reportedly useful as prognostic indicators in some cancers. However, their prognostic significance is unclear in gastric cancer (GC). Methods We enrolled 445 patients with histopathological diagnoses of gastric adenocarcinoma who had undergone curative surgeries. Results According to the optimal cut-off value of PDW and RDW by receiver operating characteristic (ROC) analysis, we divided patients into PDWHigh (≥ 16.75%), PDWLow (< 16.75%), RDWHigh (≥ 14.25%), and RDWLow (< 14.25%) subgroups. Overall survival (OS) was significantly worse in patients with PDWHigh than in those with PDWLow (P = 0.0015), as was disease specific survival (P = 0.043). OS was also significantly worse in patients with RDWHigh than in those with RDWLow (P <  0.0001), as was disease specific survival (P = 0.0002). Multivariate analysis for OS revealed that both PDW and RDW were independent prognostic indicators. Patients were then given PDW-RDW score by adding points for their different subgroups (1 point each for PDWHigh and RDWHigh; 0 points for PDWLow and RDWLow). OS significantly differed by PDW-RDW score (P <  0.0001), as did disease specific survival (P = 0.0005). In multivariate analysis for OS, PDW-RDW score was found to be an independent prognostic indicator. Conclusions The prognosis of GC patients can be precisely predictable by using both PDW and RDW.

Lymphatic Vessel Invasion As a Prognostic Factor in Patients With Primary Resected Adenocarcinomas of the Esophagogastric Junction

2005 ◽  
Vol 23 (4) ◽  
pp. 874-879 ◽  
Author(s):  
Burkhard H.A. von Rahden ◽  
Hubert J. Stein ◽  
Marcus Feith ◽  
Karen Becker ◽  
J. Rüdiger Siewert
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factor ◽  
Esophagogastric Junction ◽  
Lymphatic Vessel ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Residual Tumor ◽  
Lymphatic Vessel Invasion ◽  
Vessel Invasion ◽  
Significant Difference

Purpose To evaluate the value of lymphatic vessel invasion (LVI) as a predictor of survival in patients with primary resected adenocarcinomas of the esophagogastric junction (AEG). Patients and Methods We prospectively evaluated 459 patients undergoing primary surgical resection for tumors of the esophagogastric junction at our institution between 1992 and 2000 (180 adenocarcinomas of the distal esophagus, AEG I; 140 carcinomas of the cardia, AEG II; and 139 subcardial gastric cancers, AEG III). Median follow-up was 36.8 months. The prevalence of LVI was evaluated by two independent pathologists. Univariate and multivariate analysis of prognostic factors was performed. Results The total rate of LVI was 49.9%, with a significant difference between AEG I (38.9%) and AEGII/III (57.0%, P = .0002). Univariate analysis showed a significant correlation between LVI and T category (P < .0001), N category (P < .0001), and resection status (R [residual tumor] category; P < .0001). This was shown for the group of all AEG tumors, as well as for the subgroups AEG I and AEG II/III. On multivariate analysis, LVI was identified as a significant and independent prognostic factor (P = .050) in the population of all patients and in patients with AEG II/III, but not in the subgroup with AEG I. Conclusion These data demonstrate the prognostic significance of LVI in patients with AEG tumors, with marked differences between the subgroups AEG I versus AEG II/III. The lower prevalence and lack of prognostic significance of LVI in AEG I might be explained by inflammation involved in the pathogenesis of this entity.

scholarly journals Plasma Glutamine Levels in Relation to Intensive Care Unit Patient Outcome

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 402
Author(s):  
Renée Blaauw ◽  
Daan G. Nel ◽  
Gunter K. Schleicher
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Area Under The Curve ◽  
Threshold Value ◽  
High Plasma ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Roc Curve Analysis ◽  
Reactive Protein ◽  
Proxy Indicators

Low and high plasma glutamine levels are associated with increased mortality. This study aimed to measure glutamine levels in critically ill patients admitted to the intensive care unit (ICU), correlate the glutamine values with clinical outcomes, and identify proxy indicators of abnormal glutamine levels. Patients were enrolled from three ICUs in South Africa, provided they met the inclusion criteria. Clinical and biochemical data were collected. Plasma glutamine was categorized as low (<420 µmol/L), normal (420–700 µmol/L), or high (>700 µmol/L). Three hundred and thirty patients (median age 46.8 years, 56.4% male) were enrolled (median APACHE II score) 18.0 and SOFA) score 7.0). On admission, 58.5% had low (median 299.5 µmol/L) and 14.2% high (median 898.9 µmol/L) plasma glutamine levels. Patients with a diagnosis of polytrauma and sepsis on ICU admission presented with the lowest, and those with liver failure had the highest glutamine levels. Admission low plasma glutamine was associated with higher APACHE II scores (p = 0.003), SOFA scores (p = 0.003), C-reactive protein (CRP) values (p < 0.001), serum urea (p = 0.008), and serum creatinine (p = 0.023) and lower serum albumin (p < 0.001). Low plasma glutamine was also associated with requiring mechanical ventilation and receiving nutritional support. However, it was not significantly associated with length of stay or mortality. ROC curve analysis revealed a CRP threshold value of 87.9 mg/L to be indicative of low plasma glutamine levels (area under the curve (AUC) 0.7, p < 0.001). Fifty-nine percent of ICU patients had low plasma glutamine on admission, with significant differences found between diagnostic groupings. Markers of infection and disease severity were significant indicators of low plasma glutamine.

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