chronic health evaluation
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2021 ◽  
Vol 49 (11) ◽  
pp. e1176-e1177
Author(s):  
Eric S. Ringle ◽  
Maureen M. Stark ◽  
Laura Freeseman-Freeman ◽  
Kathy N. Henson

2021 ◽  
Author(s):  
Bo Liu ◽  
Haibo Ren ◽  
Jing Chen

Aim: Investigating correlation of lncRNA NEAT1 with Th1 and Th17 in sepsis, and their associations with inflammation, disease severity and prognosis. Materials & methods: A total of 127 sepsis patients and 50 health subjects were included. LncRNA NEAT1, Th1, Th17 and Th1/Th17-secreted cytokines were detected. Results: LncRNA NEAT1 positively correlated with Th1 and Th17 cell proportions in sepsis patients. LncRNA NEAT1 positively correlated with Th1 and Th17-secreted cytokine levels in sepsis patients. LncRNA NEAT1 and Th17 cell proportion positively correlated with CRP level, acute physiology and chronic health evaluation II score and sequential organ failure assessment score. High lncRNA NEAT1 expression, Th1 and Th17 cell proportions correlated with elevated accumulating mortality. Conclusion: LncRNA NEAT1 positively correlated with Th1 and Th17, and may serve as an assistant biomarker in sepsis patients.


2021 ◽  
Vol 29 ◽  
pp. e59116
Author(s):  
Amanda Diniz Silva ◽  
Suzel Regina Ribeiro Chavaglia ◽  
Rosali Isabel Barduchi Ohl ◽  
Maria Helena Barbosa ◽  
Fabiana Cristina Pires ◽  
...  

Objetivo: relacionar a carga de trabalho de enfermagem aos fatores associados em unidades de atendimento a pacientes em cuidados críticos. Método: estudo transversal realizado com 116 pacientes internados em um hospital público de ensino de Minas Gerais. Utilizaram-se quatro instrumentos para coleta de dados: Instrumento de Caracterização do Paciente, Sistema de Classificação de Pacientes, Nursing Activities Score e Acute Physiology and Chronic Health Evaluation II. Para a análise dos dados empregou-se frequências absolutas e relativas, medidas de resumo de posição e a variabilidade, teste t-student, correlação de Pearson e análise de regressão linear múltipla. Resultados: a média da carga de trabalho na Unidade de Terapia Intensiva e no Serviços de Urgência e Emergência foi de 20,8 h e 18,8 h e o risco de óbito foi de 22,1 e 24,4, respectivamente. Conclusão: o setor de internação e o risco de óbito influenciam na carga de trabalho de enfermagem.


2021 ◽  
Vol 13 (2) ◽  
pp. 99-113
Author(s):  
Habibah Teniya Ariq Fauziyah ◽  
Bambang Pujo Semedi ◽  
Pudji Lestari ◽  
Maulydia Maulydia

Latar belakang: Intensive care unit (ICU) adalah suatu ruangan dari rumah sakit yang khusus untuk merawat pasien yang menderita penyakit, cedera, atau komplikasi yang mengancam jiwa. Pasien yang sedang dilakukan perawatan di ICU dapat diperkirakan prognosisnya menggunakan sistem skoring.Tujuan: Untuk mengetahui hubungan antara sistem skoring acute physiological chronic health evaluation (APACHE II), sequential organ failure assessment (SOFA) hari pertama, SOFA hari ketiga, SOFA hari kelima dengan outcome pasien di ICU RSUD Dr. Soetomo Surabaya.Metode: Prospektif studi analitik observasional. Pengumpulan data dari rekam medis ICU RSUD Dr. Soetomo Surabaya. Subjek penelitiannya adalah pasien berumur ≥17 tahun yang dirawat di ICU minimal lima hari untuk kemudian dibandingkan sistem skoring APACHE II, SOFA hari pertama, SOFA hari ketiga dan SOFA hari kelima terhadap outcome pasien. Sampel penelitian bulan September 2019 hingga Januari 2020 sebanyak 110 pasien, namun yang masuk kriteria inklusi hanya 30 pasien. Data dianalisis menggunakan software SPSS 16 menggunakan uji spearman dan scatter plot.Hasil: Dari 30 pasien ICU, 56.7% berjenis kelamin laki-laki dan 43.3% berjenis kelamin perempuan, kelompok umur terbanyak 46-65 tahun (50%), indeks massa tubuh (IMT) tertinggi pada kategori IMT Normal (60%), diagnosis terbanyak adalah Sepsis sebanyak 14 pasien. (46.7%), pasien tanpa komorbiditas lebih dominan 15 pasien (50%), kondisi akhir pasien lebih banyak pada pasien yang hidup 18 pasien (60%). Hasil uji Spearman dan scatter plot menunjukkan adanya hubungan antara SOFA hari kelima dengan outcome ICU (p <0.05).Kesimpulan: Sistem penilaian SOFA hari kelima dapat memprediksi outcome ICU. Sedangkan APACHE II dan SOFA pada hari pertama dan ketiga tidak dapat memprediksi outcome ICU.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Jeroen Vandenbrande ◽  
Laurens Verbrugge ◽  
Liesbeth Bruckers ◽  
Laurien Geebelen ◽  
Ester Geerts ◽  
...  

Background. Severity scoring systems are inherent to ICU practice for multiple purposes. Acute Physiology and Chronic Health Evaluation (APACHE) scoring systems are designed for ICU mortality prediction. This study aims to validate APACHE IV in COVID-19 patients admitted to the ICU. Methods. All COVID-19 patients admitted to the ICU between March 13, 2020, and October 17, 2020, were retrospectively analyzed. APACHE II and APACHE IV scores as well as SOFA scores were calculated within 24 hours after admission. Discrimination for mortality of all three scoring systems was assessed by receiver operating characteristic curves. Youden index was determined for the scoring system with the best discriminative performance. The Hosmer–Lemeshow goodness-of-fit test was used to assess calibration. All analyses were performed for both the overall population as in a subgroup treated with anti-Xa adjusted dosages of LMWHs. Results. 116 patients were admitted to our ICU during the study period. 13 were excluded for various reasons, leaving 103 patients in the statistical analysis of the overall population. 57 patients were treated with anti-Xa adjusted prophylactic dosages of LMWH and were supplementary analyzed in a subgroup analysis. APACHE IV had the best discriminative power of the three scoring systems, both in the overall population (APACHE IV ROC AUC 0.67 vs. APACHE II ROC AUC 0.63) as in the subgroup (APACHE IV ROC AUC 0.82 vs. APACHE II ROC AUC 0.7). This model exhibits good calibration. Hosmer–Lemeshow p values for APACHE IV were 0.9234 for the overall population and 0.8017 for the subgroup. Calibration p values of the APACHE II score were 0.1394 and 0.6475 for the overall versus subgroup, respectively. Conclusions. APACHE IV provided the best discrimination and calibration of the considered scoring systems in critically ill COVID-19 patients, both in the overall group and in the subgroup with anti-Xa adjusted LMWH doses. Only in the subgroup analysis, discriminative abilities of APACHE IV were very good. This trial is registered with NCT04713852.


2021 ◽  
Vol 10 (12) ◽  
pp. 2644
Author(s):  
Yuan-Ti Lee ◽  
Chi-Chih Wang ◽  
Chien-Feng Li ◽  
Hsuan-Yi Chen ◽  
Hsien-Hua Liao ◽  
...  

Pyogenic liver abscess (PLA) is a major life-threatening disease with varied clinical features. This study aimed to determine predictors of mortality in patients with PLA using criteria determined upon admission. We retrospectively examined the data of 324 hospitalized adults in whom liver abscesses were confirmed using abdominal ultrasound and/or computed tomography. The relationship between various risk factors was assessed using multivariate analysis. A total of 109 (33.6%) patients were admitted to the intensive care unit (ICU). The overall mortality rate was 7.4% and was higher among ICU patients than non-ICU patients (21.1% vs. 0.5%, p < 0.001). PLA patients with an Acute Physiology and Chronic Health Evaluation (APACHE) II score ≥18 had a 19.31-fold increased risk, and those with concomitant infections had a 34.33-fold increased risk of 30-day mortality according to multivariate analysis. The estimated area under the receiver operating characteristic curve for predicting 30-day mortality revealed that APACHE II score ≥18 (sensitivity of 75% and specificity of 84%, p < 0.0001) had better discriminative power than Sequential Organ Failure Assessment (SOFA) ≥6 (sensitivity of 81% and specificity of 66%, p < 0.0001). APACHE II has shown better discrimination ability than SOFA in predicting mortality in PLA patients. To improve outcomes in patients with PLA, future management strategies should focus on high-risk patients.


2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Bambang Suryadi ◽  
Nurul Ainul Shifa

Pendahuluan: dalam penentuan kebutuhan dan prognosis kematian pasien diperlukan skoring kematian di Intensive care unit (ICU). Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan skoring Acute Physiology And Chronic Health Evaluation (APACHE II) terhadap angka kematian pada pasien gagal nafas di Ruang ICU Rumah Sakit PMI Bogor Tahun 2019. Metode: rancangan dalam penelitian ini adalah cross sectional. Jumlah sampel yaitu 56 pasien gagal nafas. Intrumen menggunakan lembar cheklist apache dan uji statistik menggunakan uji Chi Square. Hasil:Ada hubungan skoring APACHE II terhadap angka kematian pasien gagal nafas di Ruang ICU Rumah Sakit PMI Bogor dengan Pvalue 0,02 dan OR 4,63. Kesimpulan:Ada hubungan skoring APACHE II terhadap angka kematian pasien gagal nafas. Diharapkan perawat membuat integrasi ICU dengan perhitungan APACHE II di ruang ICU.


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