scholarly journals HUBUNGAN SKOR MODIFIED SEQUENTIAL ORGAN FAILURE ASSESSMENT (MSOFA) DENGAN KEJADIAN VENTILATOR ASSOCIATED PNEUMONIA (VAP) PADA PASIEN YANG TERPASANG VENTILATOR

2021 ◽  
Vol 11 (2) ◽  
pp. 142
Author(s):  
Hetty Yuliana ◽  
Hellena Deli ◽  
Agrina Agrina
Keyword(s):  
Retrospective Study ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Pulmonary Infection ◽  
Clinical Pulmonary Infection Score ◽  
P Value ◽  
Ventilator Associated Pneumonia ◽  
Purposive Sampling ◽  
Failure Assessment

Kegagalan multi organ pada pasien dirawat di ICU dapat meningkatkan terjadinya Ventilator Associated Pneumonia (VAP). Tujuan penelitian ini untuk melihat hubungan skor Modified Sequential Organ Failure Assessment (MSOFA) dengan kejadian VAP pada pasien yang terpasang ventilator. Desain penelitian ini adalah retrospective  study. Jumlah sampel pada penelitian ini adalah 36 orang responden yang diambil dengan teknik purposive sampling yang memenuhi kriteria inklusi. Data pada penelitian ini diperoleh dari rekam medis pasien yang dirawat di ICU dari Januari sampai Agustus 2019 diruang rekam medis. Alat ukur yang digunakan lembar observasi untuk melihat karakteristik pasien, skor MSOFA pada hari pertama dan Clinical Pulmonary Infection Score (CPIS) pada hari ketiga. Hasil penelitian ini didapatkan mayoritas diagnosis medis responden bedah saraf (44,4%), rerata untuk umur responden 52 tahun, rerata lama hari rawat 7 hari dan rerata lama pemakaian ventilator 85 jam 15 menit. Hasil analisis bivariat didapatkan nilai r 0,453, p value 0,006 lebih kecil dari nilai alpha 0,05 (p value < α). Kesimpulan terdapat hubungan antara skor MSOFA dengan kejadian VAP dan berpola positif dimana semakin tinggi skor MSOFA maka akan semakin tinggi risiko terjadi VAP, pada pasien yang terpasang ventilator di ICU RSUD Arifin Achmad Provinsi Riau. Skor MSOFA dapat memprediksi kejadian VAP sehingga dapat memotivasi perawat untuk menggunakan skor MSOFA dalam mengobservasi kejadian VAP.

The Sequential Organ Failure Assessment score and copeptin for predicting survival in ventilator-associated pneumonia

2012 ◽  
Vol 27 (5) ◽  
pp. 523.e1-523.e9 ◽  
Author(s):  
Lucas Boeck ◽  
Philippe Eggimann ◽  
Nicholas Smyrnios ◽  
Hans Pargger ◽  
Nehal Thakkar ◽  
...  
Keyword(s):  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Ventilator Associated Pneumonia ◽  
Assessment Score ◽  
Failure Assessment

scholarly journals Predictors of maternal outcome in women on mechanical ventilation in an obstetric intensive care unit: an observational study

2019 ◽  
Vol 8 (2) ◽  
pp. 721
Author(s):  
Tanu Soni ◽  
Priyadarshini Tiwari
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Observational Study ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
Coagulation System ◽  
P Value ◽  
Failure Assessment

Background: Present study was designed to note the indications for and the complications and outcome of women on mechanical ventilation in our obstetric intensive care unit, and in addition to look for the applicability and correlation of Sequential Organ Failure Assessment (SOFA) scores for the prediction of outcome in these women.Methods: A prospective observational study was conducted in the obstetric intensive care unit of our teaching hospital which included all women requiring mechanical ventilation in the study period. The diagnosis of the woman on admission, the clinical course and outcome along with total maximum sequential organ failure assessment (SOFA) score and SOFA score for each system were noted. Women were divided into two groups, survivors and non-survivors. Student t test and chi square test were used for analysis.Results: The foremost indication for mechanical ventilation was hypertension in pregnancy namely eclampsia and pre-eclampsia, followed by obstetric hemorrhage and then by hepatic failure. Maternal mortality rose significantly as the number of days of mechanical ventilation increased (p value <0.05). The total SOFA score correlated highly significantly with the outcome (p<0.0001).Conclusions: In women with eclampsia and pre-eclampsia suffering from respiratory failure, survival is inversely correlated with the number of days of mechanical ventilation. The total SOFA score is highly predictive of the woman’s outcome and all individual organ system scores also significantly correlate with outcome except for the score of coagulation system.

scholarly journals Sequential Organ Failure Assessment (SOFA) score in predicting morbidity and mortality in community and hospital acquired acute renal failure patient requiring dialysis

2018 ◽  
Vol 5 (3) ◽  
pp. 727
Author(s):  
Amit Pambhar ◽  
G. K. Mukhiya
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
P Value ◽  
Renal Failure Patient ◽  
Failure Assessment ◽  
Hospital Acquired ◽  
Excellent Tool

Background: The Sequential Organ Failure Assessment (SOFA) score is an excellent tool for assessing the extent of organ dysfunction in critically ill patients. This study was planned to compare outcome and organ failure status of community (CAARF) and hospital acquired acute renal failure (HAARF) patients requiring dialysis using SOFA score.Methods: The present prospective observational study was conducted on fifty consecutive acute renal failure patients age more than 18 years of either sex requiring dialysis. Patients who developed ARF after 24 hours of admission were referred as HAARF and patients who had acute renal failure on admission were considered as CAARF. The Sequential Organ Failure Assessment (SOFA) score was used to track a patient's status during the stay in an intensive care unit in both HAARF and CAARF patients.Results: Out of 50 patients, 31(62%) patients had community acquired renal failure and 19 (38%) patients had hospital acquired renal failure. Mean SOFA in HAARF patients was high (8.84±3.13) compare to CAARF patients (6.16± 2.80). The p value calculated was 0.003 which was significant. High SOFA Score (>11) were seen predominantly in HAARF (83.3%) patients compare to CAARF (16.7%), followed by 57.1% of patients in HAARF and 42.9% of patients in CAARF had SOFA score between 9 to11.Conclusions: High SOFA Score were seen predominantly in HAARF patients compare to CAARF and so poor outcome compare to CAARF. So, SOFA score may be used in explaining prognosis and outcome of ARF patients.

scholarly journals Incidence and Outcome of Ventilator Associated Pneumonia in ICU of a Tertiary Care Hospital in Nepal

2017 ◽  
Vol 56 (207) ◽  
pp. 304-308 ◽  
Author(s):  
Deebya Raj Mishra ◽  
Niharika Shah ◽  
Dibya Singh Shah
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pulmonary Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Pulmonary Infection Score ◽  
P Value ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Ventilated Patients

Introduction: Ventilator associated pneumonia is an important intensive care unit acquired infection in mechanically ventilated patients. Early and correct diagnosis of Ventilator associated pneumonia is difficult but is an urgent challenge for an optimal antibiotic treatment. Methods: A prospective observational study was conducted in Intensive Care Unit of a tertiary care hospital in Nepal. Consecutive patients were considered during the study period, who met the criteria were included for the study. Clinical Pulmonary Infection Score was used to diagnose Ventilator associated pneumonia. Results: Among 60 patients ventilated for more than 48 hours, 25 (41.6%) developed ventilator associated pneumonia. The incidence was 25 VAPs per 100 ventilated patients or 26 VAPs per 1000 ventilator days during the period of study. Days on ventilator and duration in ICU were higher in the VAP group. There was a trend towards increasing mortality in the VAP group (P value=0.06). Conclusions: There exists a high rate of VAP in our Intensive Care Unit. Targeted strategies aimed at reducing Ventilator associated pneumonia should be implemented to improve patient outcome and reduce length of Intensive Care Unit stay and costs. Keywords: clinical pulmonary infection score; incidence; ventilator associated pneumonia.

Does mid-regional pro-adrenomedullin (MR-proADM) improve the sequential organ failure assessment-score (SOFA score) for mortality-prediction in patients with acute infections? Results of a prospective observational study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ellen Haag ◽  
Claudia Gregoriano ◽  
Alexandra Molitor ◽  
Milena Kloter ◽  
Alexander Kutz ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
Predictive Value ◽  
Acute Infection ◽  
Mortality Prediction ◽  
P Value ◽  
Assessment Score ◽  
Failure Assessment

Abstract Objectives Risk stratification in patients with infection is usually based on the Sequential Organ Failure Assessment-Score (SOFA score). Our aim was to investigate whether the vasoactive peptide mid-regional pro-adrenomedullin (MR-proADM) improves the predictive value of the SOFA score for 30-day mortality in patients with acute infection presenting to the emergency department (ED). Methods This secondary analysis of the prospective observational TRIAGE study included 657 patients with infection. The SOFA score, MR-proADM, and traditional inflammation markers were all measured at time of admission. Associations of admission parameters and 30-day mortality were investigated by measures of logistic regression, discrimination analyses, net reclassification index (NRI), and integrated discrimination index (IDI). Results MR-proADM values were higher in non-survivors compared with survivors (4.5 ± 3.5 nmol/L vs. 1.7 ± 1.8 nmol/L) with an adjusted odds ratio of 26.6 (95% CI 3.92 to 180.61, p=0.001) per 1 nmol/L increase in admission MR-proADM levels and an area under the receiver operator curve (AUC) of 0.86. While the SOFA score alone revealed an AUC of 0.81, adding MR-proADM further improved discrimination (AUC 0.87) and classification within predefined risk categories (NRI 0.075, p-value <0.05). An admission MR-proADM threshold of 1.75 nmol/L provided the best prognostic accuracy for 30-day mortality; with a sensitivity of 81% and a specificity of 75%, and a negative predictive value of 98%. Conclusions MR-proADM improved the mortality risk stratification in patients with infection presenting to the ED beyond SOFA score alone and may further improve initial therapeutic site-of-care decisions. Trial registration ClinicalTrials.gov NCT01768494. Registered January 15, 2013.

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