- Infection
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Ability of a modified Sequential Organ Failure Assessment score to predict mortality among sepsis patients in a resource-limited setting
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Bodin Khwannimit, Rungsun Bhurayanontachai, Veerapong Vattanavanit
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Acute Crit Care. 2022;37(3):363-371. Published online August 4, 2022
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DOI: https://doi.org/10.4266/acc.2021.01627
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- Copyright © 2022 The Korean Society of
Critical Care Medicine
This is an Open Access article distributed
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https://www.accjournal.org 363
INTRODUCTION
Sepsis is a life-threatening condition and constitutes major health care problems around the world [1,2]. Sepsis was associated with nearly 20% of all global deaths, and the majority of sepsis cases occurred in low- or middle-income countries [1]. In 2017, the World Health Organization recommended actions to reduce the global burden of sepsis [2]. Sepsis has been defined as acute life-threatening organ dysfunction due to dysregulation of host responses to
Background: Some variables of the Sequential Organ Failure Assessment (SOFA) score are not routinely measured in sepsis patients, especially in countries with limited resources. Therefore, this study was conducted to evaluate the accuracy of the modified SOFA (mSOFA) and compared its ability to predict mortality in sepsis patients to that of the original SOFA score.
Methods Sepsis patients admitted to the medical intensive care unit of Songklanagarind Hospital between 2011 and 2018 were retrospectively analyzed. The primary outcome was all-cause in-hospital mortality.
Results A total of 1,522 sepsis patients were enrolled. The mean SOFA and mSOFA scores were 9.7±4.3 and 8.8±3.9, respectively. The discrimination of the mSOFA score was significantly higher than that of the SOFA score for all-cause in-hospital mortality (area under the receiver operating characteristic curve, 0.891 [95% confidence interval, 0.875–0.907] vs. 0.879 [0.862–0.896]; P<0.001), all-cause intensive care unit (ICU) mortality (0.880 [0.863–0.898] vs. 0.871 [0.853–0.889], P=0.01) and all-cause 28-day mortality (0.887 [0.871–0.904] vs. 0.874 [0.856–0.892], P<0.001). The ability of mSOFA score to predict all-cause in-hospital and 28-day mortality was higher than that of the SOFA score within the subgroups of sepsis according to age, sepsis severity and serum lactate levels. The mSOFA score was demonstrated to have a performance similar to the original SOFA score regarding the prediction of mortality in sepsis patients with cirrhosis or hepatic dysfunction.
Conclusions The mSOFA score was a good alternative to the original SOFA core in predicting mortality among sepsis patients admitted to the ICU.
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- Effects of prior antiplatelet and/or nonsteroidal anti-inflammatory drug use on mortality in patients undergoing abdominal surgery for abdominal sepsis
Se Hun Kim, Ki Hoon Kim Surgery.2023; 174(3): 611. CrossRef
- Cardiology
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The incidence of phlebitis development of high concentration of continuous amiodarone infusion with in-line filter compared to the low concentration without in-line filter: a retrospective propensity score-matched analysis
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Sirichai Cheewatanakornkul, Piyanai Vattanaprasan, Supattra Uppanisakorn, Rungsun Bhurayanontachai
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Acute Crit Care. 2022;37(3):391-397. Published online August 5, 2022
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DOI: https://doi.org/10.4266/acc.2022.00080
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4,104
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- Background
Phlebitis-associated peripheral infusion of intravenous amiodarone is common in clinical practice, with an incidence between 5% and 65%. Several factors, including drug concentration, catheter size, and in-line filter used, are significantly associated with phlebitis occurrence. We performed a retrospective propensity score-matched analysis to find out whether in-line filter will reduce the incidence of amiodarone-induced phlebitis (AIP) in high concentration of amiodarone infusion compared to low concentration without in-line filter.
Methods Clinical records of all patients who required intravenous amiodarone infusion for cardiac arrhythmias, between January 2017 to December 2019 were retrieved. The incidence of AIP was recorded and subsequently compared among high concentration (2 mg/ml) with an in-line filter and low concentration (1.5 mg/ml) infusion without an in-line filter after a 1 to 2 propensity score matched.
Results The data indicated that among the 214 cases of amiodarone infusion collected, 28 cases used an in-line filter with high concentration while 186 cases received a low concentration of amiodarone infusion without an in-line filter. After 1:2 propensity score matching, the incidence of phlebitis in the high concentration with in-line filter group was significantly higher than the low concentration without in-line filter group (28.6% vs. 3.6%, P<0.01).
Conclusions Despite the usage of in-line filter, the high concentration of amiodarone infusion resulted in a higher incidence of peripheral phlebitis. Central venous catheterization for a high concentration of amiodarone infusion is recommended.
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Citations
Citations to this article as recorded by
- The Effect of Propolis Cream on Phlebitis and Catheter-Related Bloodstream Infections: A Double-Blinded Randomised Clinical Trial
Hassan Pakdaman, Ali Khodadadizadeh, Gholamreza Bazmandegan, Hadi Hasani, Majid Kazemi Journal of Herbal Medicine.2024; 43: 100829. CrossRef
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