Not all organ dysfunctions are created equal - Prevalence and mortality in sepsis.

MedStar author(s):
Citation: Journal of Critical Care. 48:257-262, 2018 Sep 13.PMID: 30245367Institution: MedStar Institute for InnovationForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Multiple Organ Failure/ep [Epidemiology] | *Sepsis/ep [Epidemiology] | Adult | Aged | Delaware/ep [Epidemiology] | Female | Hospital Mortality | Humans | Logistic Models | Male | Middle Aged | Multiple Organ Failure/mo [Mortality] | Odds Ratio | Prevalence | Retrospective Studies | Risk Factors | Sepsis/mo [Mortality]Year: 2018Local holdings: Available online through MWHC library: 2012 - presentISSN:
  • 0883-9441
Name of journal: Journal of critical careAbstract: CONCLUSION: There exist differences in measures of organ dysfunction occurrence and their association with mortality. These findings support increased clinical efforts to identify sepsis patients to inform diagnostic decisions.Copyright (c) 2018 Elsevier Inc. All rights reserved.MATERIALS AND METHODS: Descriptive and multivariate analyses of retrospective data including patients (age>=18years) hospitalized at the study hospital from July 2013 to April 2016 who met the criteria for an infection visit (62,057 unique visits).PURPOSE: While organ dysfunctions within sepsis have been widely studied, interaction between measures of organ dysfunction remains an understudied area. The objective of this study is to quantify the impact of organ dysfunction on in-hospital mortality in infected population.RESULTS: The multivariate logistic regression model had an area under the curve of 0.9. Highest odds ratio (OR) associated with increased mortality risk was identified as fraction of inspired oxygen (FiO<sub>2</sub>)>21% (OR=5.8 and 95% Confidence Interval (CI) 1.8-35.6), and elevated lactate >2.0mmol/L (OR=2.45 (95% CI=2.1-2.8)). Most commonly observed measures of organ dysfunction within mortality visits included elevated lactate (> 2.0mmol/L), mechanical ventilation, and oxygen saturation (SpO<sub>2</sub>)/FiO<sub>2</sub> ratio (< 421) at least once within 48h prior to or 24h after anti-infective administration.All authors: Arnold R, Capan M, Hoover S, Ivy JS, Miller KE, S.E.P.S.I.S (Sepsis Early Prediction Support Implementation System) CollaborativeFiscal year: FY2019Digital Object Identifier: Date added to catalog: 2018-09-28
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 30245367 Available 30245367

Available online through MWHC library: 2012 - present

CONCLUSION: There exist differences in measures of organ dysfunction occurrence and their association with mortality. These findings support increased clinical efforts to identify sepsis patients to inform diagnostic decisions.

Copyright (c) 2018 Elsevier Inc. All rights reserved.

MATERIALS AND METHODS: Descriptive and multivariate analyses of retrospective data including patients (age>=18years) hospitalized at the study hospital from July 2013 to April 2016 who met the criteria for an infection visit (62,057 unique visits).

PURPOSE: While organ dysfunctions within sepsis have been widely studied, interaction between measures of organ dysfunction remains an understudied area. The objective of this study is to quantify the impact of organ dysfunction on in-hospital mortality in infected population.

RESULTS: The multivariate logistic regression model had an area under the curve of 0.9. Highest odds ratio (OR) associated with increased mortality risk was identified as fraction of inspired oxygen (FiO<sub>2</sub>)>21% (OR=5.8 and 95% Confidence Interval (CI) 1.8-35.6), and elevated lactate >2.0mmol/L (OR=2.45 (95% CI=2.1-2.8)). Most commonly observed measures of organ dysfunction within mortality visits included elevated lactate (> 2.0mmol/L), mechanical ventilation, and oxygen saturation (SpO<sub>2</sub>)/FiO<sub>2</sub> ratio (< 421) at least once within 48h prior to or 24h after anti-infective administration.

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