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  • Articles

    Systemic inflammatory response syndrome criteria and the prediction of hospital mortality in critically ill patients: a retrospective cohort study

    Rev Bras Ter Intensiva. 2017;29(3):317-324

    Abstract

    Articles

    Systemic inflammatory response syndrome criteria and the prediction of hospital mortality in critically ill patients: a retrospective cohort study

    Rev Bras Ter Intensiva. 2017;29(3):317-324

    DOI 10.5935/0103-507X.20170047

    Views4

    ABSTRACT

    Objective:

    This study intended to determine whether the systemic inflammatory response syndrome criteria can predict hospital mortality in a Brazilian cohort of critically ill patients.

    Methods:

    We performed a retrospective cohort study at a private tertiary hospital in São Paulo (SP), Brazil. We extracted information from the adult intensive care unit database (Sistema EpimedTM). We compared the SAPS 3 and the systemic inflammatory response syndrome model as dichotomous (≥ 2 criteria: systemic inflammatory response syndrome -positive versus 0 - 1 criterion: systemic inflammatory response syndrome -negative) and ordinal variables from 0 to 4 (according to the number of systemic inflammatory response syndrome criteria met) in the prediction of hospital mortality at intensive care unit admission. Model discrimination was compared using the area under the receiver operating characteristics (AUROC) curve.

    Results:

    From January to December 2012, we studied 932 patients (60.4% were systemic inflammatory response syndrome -positive). systemic inflammatory response syndrome -positive patients were more critically ill than systemic inflammatory response syndrome -negative patients and had higher hospital mortality (16.9% versus 8.1%, p < 0.001). In the adjusted analysis, being systemic inflammatory response syndrome -positive independently increased the risk of death by 82% (odds ratio 1.82; 95% confidence interval [CI] 1.12 - 2.96, p = 0.016). However, the AUROC curve for the SAPS 3 model was higher (0.81, 95%CI 0.78 - 0.85) compared to the systemic inflammatory response syndrome model with the systemic inflammatory response syndrome criteria as a dichotomous variable (0.60, 95%CI 0.55 - 0.65) and as an ordinal variable (0.62, 95%CI 0.57 - 0.68; p < 0.001) for hospital mortality.

    Conclusion:

    Although systemic inflammatory response syndrome is associated with hospital mortality, the systemic inflammatory response syndrome criteria show low accuracy in the prediction of mortality compared with the SAPS 3.

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    Systemic inflammatory response syndrome criteria and the prediction of hospital mortality in critically ill patients: a retrospective cohort study
  • Original Article

    Admission factors associated with intensive care unit readmission in critically ill oncohematological patients: a retrospective cohort study

    Rev Bras Ter Intensiva. 2016;28(1):33-39

    Abstract

    Original Article

    Admission factors associated with intensive care unit readmission in critically ill oncohematological patients: a retrospective cohort study

    Rev Bras Ter Intensiva. 2016;28(1):33-39

    DOI 10.5935/0103-507X.20160011

    Views2

    ABSTRACT

    Objective:

    The purpose of our study was to determine the admission factors associated with intensive care unit readmission among oncohematological patients.

    Methods:

    Retrospective cohort study using an intensive care unit database from a tertiary oncological center. The participants included 1,872 critically ill oncohematological patients who were admitted to the intensive care unit from January 2012 to December 2014 and who were subsequently discharged alive. We used univariate and multivariate analysis to identify the admission risk factors associated with later intensive care unit readmission.

    Results:

    One hundred seventy-two patients (9.2% of 1,872 oncohematological patients discharged alive from the intensive care unit) were readmitted after intensive care unit discharge. The readmitted patients were sicker compared with the non-readmitted group and had higher hospital mortality (32.6% versus 3.7%, respectively; p < 0.001). In the multivariate analysis, the independent risk factors for intensive care unit readmission were male sex (OR: 1.5, 95% CI: 1.07 - 2.12; p = 0.019), emergency surgery as the admission reason (OR: 2.91, 95%CI: 1.53 - 5.54; p = 0.001), longer hospital length of stay before intensive care unit transfer (OR: 1.02, 95%CI: 1.007 - 1.035; p = 0.003), and mechanical ventilation (OR: 2.31, 95%CI: 1.57 - 3.40; p < 0.001).

    Conclusions:

    In this cohort of oncohematological patients, we identified some risk factors associated with intensive care unit readmission, most of which are not amenable to interventions. The identification of risk factors at intensive care unit discharge might be a promising approach.

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    Admission factors associated with intensive care unit readmission in critically ill oncohematological patients: a retrospective cohort study
  • Letters to the Editor

    Reply to: Admission factors associated with intensive care unit readmission in critically ill oncohematological patients: a retrospective cohort study

    Rev Bras Ter Intensiva. 2016;28(3):354-355

    Abstract

    Letters to the Editor

    Reply to: Admission factors associated with intensive care unit readmission in critically ill oncohematological patients: a retrospective cohort study

    Rev Bras Ter Intensiva. 2016;28(3):354-355

    DOI 10.5935/0103-507X.20160062

    Views1
    We would like to thank you for the interest in our study about admission factors associated with later readmission to the intensive care unit (ICU) in an oncohematological cohort.() Aydoğdu and Esquinas correctly acknowledged that only evaluating ICU admission factors limited our analysis. Unfortunately, we evaluated an administrative database, which only had some physiological information […]
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