You searched for:"Valeska Fernandes Pasinato"
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Original Article
SAPS 3 in the modified NUTrition RIsk in the Critically ill score has comparable predictive accuracy to APACHE II as a severity marker
- Valeska Fernandes Pasinato
, - Oellen Stuani Franzosi ,
- Sérgio Henrique Loss ,
- Diego Silva Leite Nunes,
- Kelly Carraro Foletto, [ … ],
- Silvia Regina Rios Vieira
Abstract
Original ArticleSAPS 3 in the modified NUTrition RIsk in the Critically ill score has comparable predictive accuracy to APACHE II as a severity marker
Rev Bras Ter Intensiva. 2021;33(3):394-400
DOI 10.5935/0103-507X.20210064
- Valeska Fernandes Pasinato ,
- Oellen Stuani Franzosi ,
- Sérgio Henrique Loss ,
- Diego Silva Leite Nunes,
- Kelly Carraro Foletto,
- Gabriela Soranço Salazar,
- Silvia Regina Rios Vieira
Views2ABSTRACT
Objective:
To evaluate the substitution of Acute Physiology and Chronic Health Evaluation II (APACHE II) by Simplified Acute Physiology Score 3 (SAPS 3) as a severity marker in the modified version of the NUTrition RIsk in the Critically ill score (mNUTRIC); without interleukin 6) based on an analysis of its discriminative ability for in-hospital mortality prediction.
Methods:
This retrospective cohort study evaluated 1,516 adult patients admitted to an intensive care unit of a private general hospital from April 2017 to January 2018. Performance evaluation included Fleiss’ Kappa and Pearson correlation analysis. The discriminative ability for estimating in-hospital mortality was assessed with the Receiver Operating Characteristic curve.
Results:
The sample was randomly divided into two-thirds for model development (n = 1,025; age 72 [57 – 83]; 52.4% male) and one-third for performance evaluation (n = 490; age 72 [57 – 83]; 50.8% male). The agreement with mNUTRIC was Kappa of 0.563 (p < 0.001), and the correlation between the instruments was Pearson correlation of 0.804 (p < 0.001). The tool showed good performance in predicting in-hospital mortality (area under the curve 0.825 [0.787 - 0.863] p < 0.001).
Conclusion:
The substitution of APACHE II by SAPS 3 as a severity marker in the mNUTRIC score showed good performance in predicting in-hospital mortality. These data provide the first evidence regarding the validity of the substitution of APACHE II by SAPS 3 in the mNUTRIC as a marker of severity. Multicentric studies and additional analyses of nutritional adequacy parameters are required.
Keywords:APACHECritical careMortalitynutritional assessmentSeverity of illness indexSimplified acute physiology scoreSee moreViews2
Abstract
Original ArticleSAPS 3 in the modified NUTrition RIsk in the Critically ill score has comparable predictive accuracy to APACHE II as a severity marker
Rev Bras Ter Intensiva. 2021;33(3):394-400
DOI 10.5935/0103-507X.20210064
- Valeska Fernandes Pasinato ,
- Oellen Stuani Franzosi ,
- Sérgio Henrique Loss ,
- Diego Silva Leite Nunes,
- Kelly Carraro Foletto,
- Gabriela Soranço Salazar,
- Silvia Regina Rios Vieira
Views2ABSTRACT
Objective:
To evaluate the substitution of Acute Physiology and Chronic Health Evaluation II (APACHE II) by Simplified Acute Physiology Score 3 (SAPS 3) as a severity marker in the modified version of the NUTrition RIsk in the Critically ill score (mNUTRIC); without interleukin 6) based on an analysis of its discriminative ability for in-hospital mortality prediction.
Methods:
This retrospective cohort study evaluated 1,516 adult patients admitted to an intensive care unit of a private general hospital from April 2017 to January 2018. Performance evaluation included Fleiss’ Kappa and Pearson correlation analysis. The discriminative ability for estimating in-hospital mortality was assessed with the Receiver Operating Characteristic curve.
Results:
The sample was randomly divided into two-thirds for model development (n = 1,025; age 72 [57 – 83]; 52.4% male) and one-third for performance evaluation (n = 490; age 72 [57 – 83]; 50.8% male). The agreement with mNUTRIC was Kappa of 0.563 (p < 0.001), and the correlation between the instruments was Pearson correlation of 0.804 (p < 0.001). The tool showed good performance in predicting in-hospital mortality (area under the curve 0.825 [0.787 - 0.863] p < 0.001).
Conclusion:
The substitution of APACHE II by SAPS 3 as a severity marker in the mNUTRIC score showed good performance in predicting in-hospital mortality. These data provide the first evidence regarding the validity of the substitution of APACHE II by SAPS 3 in the mNUTRIC as a marker of severity. Multicentric studies and additional analyses of nutritional adequacy parameters are required.
Keywords:APACHECritical careMortalitynutritional assessmentSeverity of illness indexSimplified acute physiology scoreSee more
- Valeska Fernandes Pasinato
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Original Articles – Clinical Research
Enteral nutritional therapy in septic patients in the intensive care unit: compliance with nutritional guidelines for critically ill patients
Rev Bras Ter Intensiva. 2013;25(1):17-24
Abstract
Original Articles – Clinical ResearchEnteral nutritional therapy in septic patients in the intensive care unit: compliance with nutritional guidelines for critically ill patients
Rev Bras Ter Intensiva. 2013;25(1):17-24
DOI 10.1590/S0103-507X2013000100005
Views0OBJECTIVE: Evaluate the compliance of septic patients’ nutritional management with enteral nutrition guidelines for critically ill patients. METHODS: Prospective cohort study with 92 septic patients, age ≥18 years, hospitalized in an intensive care unit, under enteral nutrition, evaluated according to enteral nutrition guidelines for critically ill patients, compliance with caloric and protein goals, and reasons for not starting enteral nutrition early or for discontinuing it. Prognostic scores, length of intensive care unit stay, clinical progression, and nutritional status were also analyzed. RESULTS: The patients had a mean age of 63.4±15.1 years, were predominantly male, were diagnosed predominantly with septic shock (56.5%), had a mean intensive care unit stay of 11 (7.2 to 18.0) days, had 8.2±4.2 SOFA and 24.1±9.6 APACHE II scores, and had 39.1% mortality. Enteral nutrition was initiated early in 63% of patients. Approximately 50% met the caloric and protein goals on the third day of intensive care unit stay, a percentage that decreased to 30% at day 7. Reasons for the late start of enteral nutrition included gastrointestinal tract complications (35.3%) and hemodynamic instability (32.3%). Clinical procedures were the most frequent reason to discontinue enteral nutrition (44.1%). There was no association between compliance with the guidelines and nutritional status, length of intensive care unit stay, severity, or progression. CONCLUSION: Although the number of septic patients under early enteral nutrition was significant, caloric and protein goals at day 3 of intensive care unit stay were met by only half of them, a percentage that decreased at day 7.
Keywords:enteral nutritionGuidelines as topicIntensive careIntensive care unitsnutrition therapySepsisSee moreViews0Abstract
Original Articles – Clinical ResearchEnteral nutritional therapy in septic patients in the intensive care unit: compliance with nutritional guidelines for critically ill patients
Rev Bras Ter Intensiva. 2013;25(1):17-24
DOI 10.1590/S0103-507X2013000100005
Views0OBJECTIVE: Evaluate the compliance of septic patients’ nutritional management with enteral nutrition guidelines for critically ill patients. METHODS: Prospective cohort study with 92 septic patients, age ≥18 years, hospitalized in an intensive care unit, under enteral nutrition, evaluated according to enteral nutrition guidelines for critically ill patients, compliance with caloric and protein goals, and reasons for not starting enteral nutrition early or for discontinuing it. Prognostic scores, length of intensive care unit stay, clinical progression, and nutritional status were also analyzed. RESULTS: The patients had a mean age of 63.4±15.1 years, were predominantly male, were diagnosed predominantly with septic shock (56.5%), had a mean intensive care unit stay of 11 (7.2 to 18.0) days, had 8.2±4.2 SOFA and 24.1±9.6 APACHE II scores, and had 39.1% mortality. Enteral nutrition was initiated early in 63% of patients. Approximately 50% met the caloric and protein goals on the third day of intensive care unit stay, a percentage that decreased to 30% at day 7. Reasons for the late start of enteral nutrition included gastrointestinal tract complications (35.3%) and hemodynamic instability (32.3%). Clinical procedures were the most frequent reason to discontinue enteral nutrition (44.1%). There was no association between compliance with the guidelines and nutritional status, length of intensive care unit stay, severity, or progression. CONCLUSION: Although the number of septic patients under early enteral nutrition was significant, caloric and protein goals at day 3 of intensive care unit stay were met by only half of them, a percentage that decreased at day 7.
Keywords:enteral nutritionGuidelines as topicIntensive careIntensive care unitsnutrition therapySepsisSee more -
Original Articles – Clinical Research
Bioelectrical impedance phase angle in septic patients admitted to intensive care units
Rev Bras Ter Intensiva. 2013;25(1):25-31
Abstract
Original Articles – Clinical ResearchBioelectrical impedance phase angle in septic patients admitted to intensive care units
Rev Bras Ter Intensiva. 2013;25(1):25-31
DOI 10.1590/S0103-507X2013000100006
Views0See moreOBJECTIVE: To calculate the values of the phase angle of septic patients using bioelectrical impedance analysis, correlate the values with clinical and biochemical variables, and compare them to reference values. METHODS: Cohort study conducted with 50 septic patients aged ≥18 years old, admitted to intensive care units, and assessed according to prognostic indexes (APACHE II and SOFA), clinical progression (mortality, severity of sepsis, length of stay in intensive care unit), biochemical parameters (albumin and C-reactive protein), and the phase angle. RESULTS: The average age of the sample was 65.6±16.5 years. Most patients were male (58%) and suffering from septic shock (60%). The average APACHE II and SOFA scores were 22.98±7.1 and 7.5±3.4, respectively. The patients who survived stayed nine days on average (five to 13) in the intensive care unit, and the mortality rate was 30%. The average value of the phase angle was 5.4±2.6° in the total sample and was smaller among the females compared with the males (p=0.01). The phase angle measures did not exhibit an association with the severity of the sepsis, mortality, gender, and age or correlate with the length of hospitalization or the biochemical parameters. The participants’ phase angle values adjusted per gender and age were 1.1 to 1.9 times lower compared with the values for a normal population. CONCLUSION: The average value of the phase angle of septic patients was lower compared with the reference values for a healthy population. The phase angle measures did not exhibit association with the clinical and biochemical variables, which might be explained by the sample homogeneity.
Views0Abstract
Original Articles – Clinical ResearchBioelectrical impedance phase angle in septic patients admitted to intensive care units
Rev Bras Ter Intensiva. 2013;25(1):25-31
DOI 10.1590/S0103-507X2013000100006
Views0See moreOBJECTIVE: To calculate the values of the phase angle of septic patients using bioelectrical impedance analysis, correlate the values with clinical and biochemical variables, and compare them to reference values. METHODS: Cohort study conducted with 50 septic patients aged ≥18 years old, admitted to intensive care units, and assessed according to prognostic indexes (APACHE II and SOFA), clinical progression (mortality, severity of sepsis, length of stay in intensive care unit), biochemical parameters (albumin and C-reactive protein), and the phase angle. RESULTS: The average age of the sample was 65.6±16.5 years. Most patients were male (58%) and suffering from septic shock (60%). The average APACHE II and SOFA scores were 22.98±7.1 and 7.5±3.4, respectively. The patients who survived stayed nine days on average (five to 13) in the intensive care unit, and the mortality rate was 30%. The average value of the phase angle was 5.4±2.6° in the total sample and was smaller among the females compared with the males (p=0.01). The phase angle measures did not exhibit an association with the severity of the sepsis, mortality, gender, and age or correlate with the length of hospitalization or the biochemical parameters. The participants’ phase angle values adjusted per gender and age were 1.1 to 1.9 times lower compared with the values for a normal population. CONCLUSION: The average value of the phase angle of septic patients was lower compared with the reference values for a healthy population. The phase angle measures did not exhibit association with the clinical and biochemical variables, which might be explained by the sample homogeneity.
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Case reports Child Coronavirus infections COVID-19 Critical care Critical illness Extracorporeal membrane oxygenation Infant, newborn Intensive care Intensive care units Intensive care units, pediatric mechanical ventilation Mortality Physical therapy modalities Prognosis Respiration, artificial Respiratory insufficiency risk factors SARS-CoV-2 Sepsis