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The use of APACHE II, SOFA, SAPS 3, C-reactive protein/albumin ratio, and lactate to predict mortality of surgical critically ill patients: A retrospective cohort study.

作者信息

Basile-Filho Anibal, Lago Alessandra Fabiane, Menegueti Mayra Gonçalves, Nicolini Edson Antonio, Rodrigues Lorena Aparecida de Brito, Nunes Roosevelt Santos, Auxiliadora-Martins Maria, Ferez Marcus Antonio

机构信息

Division of Intensive Care Medicine, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo.

Intensive Care Unit, Hospital das Clínicas de Ribeirão Preto.

出版信息

Medicine (Baltimore). 2019 Jun;98(26):e16204. doi: 10.1097/MD.0000000000016204.

DOI:10.1097/MD.0000000000016204
PMID:31261567
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6617482/
Abstract

Several prognostic indices have been employed to predict the outcome of surgical critically ill patients. Among them, acute physiology and chronic health evaluation (APACHE) II, sequential organ failure assessment (SOFA) and simplified acute physiology score (SAPS 3) are widely used. It seems that biological markers such as C-reactive protein (CRP), albumin, and blood lactate levels correlate with the degree of inflammation during the immediate postoperative phase and could be used as independent predictors. The objective of this study is to compare the different predictive values of prognostic indices and biological markers in the outcome of 847 surgical patients admitted to the intensive care unit (ICU) in the postoperative phase.The patients were divided into survivors (n = 765, 57.4% males, age 61, interquartile range 51-71) and nonsurvivors (n = 82, 57.3% males, age 70, interquartile range 58-79). APACHE II, APACHE II death probability (DP), SOFA, SAPS 3, SAPS 3 DP, CRP, albumin, and lactate were recorded on ICU admission (first 24 hours). The area under the ROC curve (AUROC) and 95% confidence interval (95% CI) were used to measure the index accuracy to predict mortality.The AUROC and 95% CI for APACHE II, APACHE II DP, SOFA, SAPS 3, SAPS 3 DP, CRP/albumin ratio, CRP, albumin, and lactate were 0.850 (0.824-0.873), 0.855 (0.829-0.878), 0.791 (0.762-0.818), 0.840 (0.813-0.864), 0.840 (0.813-0.864), 0.731 (0.700-0.761), 0.708 (0.676-0.739), 0.697 (0.665-0.728), and 0.601 (0.567-0.634), respectively. The ICU and overall in-hospital mortality were 6.6 and 9.7%, respectively. The APACHE II, APACHE II DP, SAPS 3, SAPS 3 DP, and SOFA scores showed a better performance than CRP/albumin ratio, CRP, albumin, or lactate to predict in-hospital mortality of surgical critically ill patients.Even though all indices were able to discriminate septic from nonseptic patients, only APACHE II, APACHE II DP, SOFA and to a lesser extent SAPS 3, SAPS 3 DP, and blood lactate levels could predict in the first 24-hour ICU admission surgical patients who have survived sepsis.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6b6/6617482/7f7d200b582c/medi-98-e16204-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6b6/6617482/6491f240d961/medi-98-e16204-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6b6/6617482/7f7d200b582c/medi-98-e16204-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6b6/6617482/6491f240d961/medi-98-e16204-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6b6/6617482/7f7d200b582c/medi-98-e16204-g005.jpg

相似文献

[1]
The use of APACHE II, SOFA, SAPS 3, C-reactive protein/albumin ratio, and lactate to predict mortality of surgical critically ill patients: A retrospective cohort study.

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本文引用的文献

[1]
Is postoperative decrease of serum albumin an early predictor of complications after major abdominal surgery? A prospective cohort study in a European centre.

BMJ Open. 2017-4-8

[2]
C-reactive protein (CRP) measurement in geriatric patients hospitalized for acute infection.

Eur J Intern Med. 2017-1

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JAMA. 2016-2-23

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Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot Study.

Gastroenterol Res Pract. 2016

[8]
Hypoalbuminemia Within Two Postoperative Days Is an Independent Risk Factor for Acute Kidney Injury Following Living Donor Liver Transplantation: A Propensity Score Analysis of 998 Consecutive Patients.

Crit Care Med. 2015-12

[9]
The C-Reactive Protein/Albumin Ratio as an Independent Predictor of Mortality in Patients with Severe Sepsis or Septic Shock Treated with Early Goal-Directed Therapy.

PLoS One. 2015-7-9

[10]
Diagnostic value of C-reactive protein to rule out infectious complications after major abdominal surgery: a systematic review and meta-analysis.

Int J Colorectal Dis. 2015-7

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