التفاصيل البيبلوغرافية
| العنوان: |
Prediction of in-hospital death for sepsis or septic shock in internal medicine. Results from a multi center study: the SOFA-T score |
| المؤلفون: |
Zaccone V, Falsetti L, Martino M, Tarquinio N, Di Pentima C, Martini A, Fioranelli A, Nitti C, Viticchi G, Pellegrini F, Burattini M, Salvi A |
| المساهمون: |
Zaccone V, Falsetti L, Martino M,Tarquinio N, Di Pentima C, Martini A, Fioranelli A, Nitti C, Viticchi G, Pellegrini F, Burattini M, Salvi A |
| بيانات النشر: |
ITA |
| سنة النشر: |
2018 |
| المجموعة: |
IRIS Università degli Studi di Bologna (CRIS - Current Research Information System) |
| مصطلحات موضوعية: |
septic shock, severe sepsi, SOFA score |
| الوصف: |
Background: The Sequential Organ Failure Assessment (SOFA) score is used to predict prognosis in subjects affected by severe sepsis and septic shock (SS). Troponin I (TnI) has been associated to worse outcomes in this setting. Internal and emergency departments often manage elderly patients affected by SS, often coaffected by several pathologies. In this setting, however, no prognostic index has been evaluated and data on survival and prognosis are derived from cohorts of patients treated in intensive care units. Patients and Methods:in the years 2015-2017 we enrolled all the consecutive patients admitted for SS in two Internal Medicine departments with expertise in critical care medicine. For each patient, we evaluated, at the admission: (1) SOFA score (2) TnI level (3) sex, age and comorbidities. Main outcome was defined as in-hospital mortality. We chose the best cutoff value for TnI and in-hospital death with ROC curve analysis, adopting Youden index. Then we calculated SOFA-T score adding 1 point to SOFA score if the admission TnI was above the calculated cutoff. Last, we compared the ROC curves of SOFA and SOFA-T with DeHanley method. Results: 390 subjects (age:79,6±11,4;males:49,2%) with 144 (36,9%) deaths; median SOFA score was 6 (0-15); mean TnI was 1,46 ng/ml (IQR:0,35). TnI predicted significantly the outcome (AUC:0,61;95%CI:0,56-0,66;p=0,0003) with an optimal cutoff of 0,315 ng/ml: TnI above this cutoff was associated to an increased risk of death for SS (OR:2,28;95%CI:1,68-3,07;p<0,0001). In this clinical setting, SOFA score showed a good predictive performance (AUC:0,68;95%CI:0,64-0,73;p<0,0001), which was significantly improved in SOFA-T (AUC:0,70;95%CI:0,65-0,75;p<0,0001). The difference between SOFA and SOFA-T was significant (AUC difference:0,15;p=0,001). Results the determination of TnI at the admission and its integration in a validated scoring system as SOFA can improve the prediction of in-hospital death of elderly patients affected by SS. |
| نوع الوثيقة: |
conference object |
| وصف الملف: |
STAMPA |
| اللغة: |
English |
| Relation: |
ispartofbook:Volume Comunicazioni Orali e Poster 119° Congresso Nazionale della Società Italiana di Medicina Interna; 119° Congresso Nazionale della Società Italiana di Medicina Interna; firstpage:142; lastpage:142; numberofpages:1; http://hdl.handle.net/11585/655569 |
| الاتاحة: |
http://hdl.handle.net/11585/655569 |
| رقم الانضمام: |
edsbas.BD2DED3A |
| قاعدة البيانات: |
BASE |