Alanya Alaaddin Keykubat University, Faculty of Medicine, Department of Pulmonology, Alanya, Antalya, Turkey.
University of Health Sciences Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, Department of Pulmonology, Ankara, Turkey.
Medicine (Baltimore). 2022 Feb 11;101(6):e28840. doi: 10.1097/MD.0000000000028840.
We aimed to determine the parameters that affect mortality in pulmonary intensive care units that are faster and inexpensive to determine than existing scoring systems. The relationship between serum osmolarity and prognosis was demonstrated for predialysis patients, in acute pulmonary embolism, heart failure, acute coronary syndrome, myocardial infarction, and acute spontaneous intracerebral hemorrhage in the literature. We hypothesized that serum osmolarity, which is routinely evaluated, may have prognostic significance in patients with respiratory failure.This study comprised 449 patients treated in the Pulmonary Intensive Care Clinic (PICU) of our hospital between January 1, 2020, and December 31, 2020. The modified Charlson Comorbidity Index (mCCI), Acute Physiology and Chronic Health Assessment (APACHE II), Sequential Organ Failure Evaluation Score (SOFA), Nutrition Risk Screening 2002 (NRS-2002), and hospitalization serum osmolarity levels were measured.Of the 449 patients included in the study, 65% (n = 292) were female and the mean age of all patients was 69.86 ± 1.72 years. About 83.1% (n = 373) of the patients included in the study were discharged with good recovery. About 4.9% (n = 22) were transferred to the ward because their intensive care needs were over. About 6.9% (n = 31) were transferred to the tertiary intensive care unit after their status deteriorated. About 5.1% (n = 23) died in the PICU. In the mortality group, APACHE II (P = .005), mCCI (P < .001), NRS-2002 total score (P < .001), and SOFA score (P < .001) were significantly higher. There was no statistically significant difference between the groups in terms of serum osmolarity levels.Although we could not determine serum osmolarity as a practical method to predict patient prognosis in this study, we assume that our results will guide future studies on this subject.
我们旨在确定比现有评分系统更快、更经济实惠的影响肺重症监护病房死亡率的参数。文献中已经证明了血清渗透压与透析前患者的急性肺栓塞、心力衰竭、急性冠状动脉综合征、心肌梗死和急性自发性脑出血之间的关系。我们假设,在呼吸衰竭患者中,常规评估的血清渗透压可能具有预后意义。
这项研究包括了 2020 年 1 月 1 日至 12 月 31 日期间在我们医院的肺重症监护病房(PICU)接受治疗的 449 名患者。测量了改良 Charlson 合并症指数(mCCI)、急性生理学和慢性健康评估(APACHE II)、序贯器官衰竭评估评分(SOFA)、营养风险筛查 2002(NRS-2002)和住院期间的血清渗透压水平。
在纳入研究的 449 名患者中,65%(n=292)为女性,所有患者的平均年龄为 69.86±1.72 岁。研究中纳入的患者中有 83.1%(n=373)出院时恢复良好。约 4.9%(n=22)因需要的重症监护治疗结束而转入病房。约 6.9%(n=31)因病情恶化转入三级重症监护病房。约 5.1%(n=23)在 PICU 死亡。在死亡组中,APACHE II(P=0.005)、mCCI(P<0.001)、NRS-2002 总分(P<0.001)和 SOFA 评分(P<0.001)显著更高。两组之间的血清渗透压水平没有统计学上的显著差异。
尽管我们不能确定血清渗透压作为预测患者预后的实用方法,但我们假设我们的结果将指导这一主题的未来研究。