Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/1428
Título: Sepsis Mortality Prediction Based on Predisposition, Infection and Response
Autor: Moreno, R
Metnitz, B
Adler, L
Hoechtl, A
Bauer, P
Metnitz, P
SAPS 3 Investigators
Palavras-chave: Doença Crónica
Infecções Comunitárias Adquiridas
Infecção Hospitalar
Mortalidade
Bases de Dados Factuais
Susceptibilidade a Doença
Infecções por Bactérias Gram-Positivas
Mortalidade Hospitalar
Unidades de Cuidados Intensivos
Sépsis
Índice de Gravidade da Doença
Insuficiência de Múltiplos Órgãos
Choque Séptico
Microbiologia
Síndrome de Resposta Inflamatória Sistémica
Data: 2008
Editora: Springer
Citação: Intensive Care Med. 2008 Mar;34(3):496-504
Resumo: OBJECTIVE: To empirically test, based on a large multicenter, multinational database, whether a modified PIRO (predisposition, insult, response, and organ dysfunction) concept could be applied to predict mortality in patients with infection and sepsis. DESIGN: Substudy of a multicenter multinational cohort study (SAPS 3). PATIENTS: A total of 2,628 patients with signs of infection or sepsis who stayed in the ICU for >48 h. Three boxes of variables were defined, according to the PIRO concept. Box 1 (Predisposition) contained information about the patient's condition before ICU admission. Box 2 (Injury) contained information about the infection at ICU admission. Box 3 (Response) was defined as the response to the infection, expressed as a Sequential Organ Failure Assessment score after 48 h. INTERVENTIONS: None. MAIN MEASUREMENTS AND RESULTS: Most of the infections were community acquired (59.6%); 32.5% were hospital acquired. The median age of the patients was 65 (50-75) years, and 41.1% were female. About 22% (n=576) of the patients presented with infection only, 36.3% (n=953) with signs of sepsis, 23.6% (n=619) with severe sepsis, and 18.3% (n=480) with septic shock. Hospital mortality was 40.6% overall, greater in those with septic shock (52.5%) than in those with infection (34.7%). Several factors related to predisposition, infection and response were associated with hospital mortality. CONCLUSION: The proposed three-level system, by using objectively defined criteria for risk of mortality in sepsis, could be used by physicians to stratify patients at ICU admission or shortly thereafter, contributing to a better selection of management according to the risk of death.
Peer review: yes
URI: http://hdl.handle.net/10400.17/1428
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