Nomogram to predict a poor outcome in emergency patients with sepsis and at low risk of organ damage according to Sepsis-related Organ Failure Assessment (SOFA)
OBJECTIVES: To develop a nomograph to predict a poor outcome (death during hospitalization or a hospital stay longer than 15 days) in emergency patients with sepsis and at low risk of organ damage according to Sepsis-related Organ Failure Assessment (SOFA).
MATERIAL AND METHODS: Prospective, observational study carried out in a single universitary hospital. All patients admitted from the emergency department with sepsis and SOFA scores of 6 or lower were enrolled. We used bivariate logistic regression analysis to develop a predictive nomogram.
RESULTS: A total of 174 patients were included. Seventeen patients (9.8%) died during hospitalization and the average hospital stay was greater than 15 days in 29 (16.7%) patient. The outcome was poor in a total of 42 patients (24.1%);. Independent variables that were significantly associated with a poor outcome were SOFA score (odds ratio [OR], 1.3; 95% CI, 1.06-1.71; P<.05), C-reactive protein (CRP) concentration (OR, 1.04; 95% CI, 1.0-1.09; P<.05), N-terminal fragment of brain natriuretic peptide (NT-proBNP) concentration over 1330 ng/mL (OR, 2.64; 95% CI, 1.17-6.22; P<.05), and septic shock (OR, 8.3; 95% CI, 1.16-166.5; P<.05). For a SOFA score of 2 or more the crude OR was 4.44 (95%, CI, 1.91-10.34) and the OR adjusted for other variables was 3.08 (95% CI, 1.24-7.69).
CONCLUSION: A high percentage of patients predicted to be at low risk of organ failure had poor outcomes, associated with SOFA score, the presence of septic shock, CRP concentration, and elevated NT-proBNP concentration. The SOFA score by itself is an inadequate prognostic tool in patients at low risk of organ damage. Other clinical and analytical variables are required to complement the SOFA score.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias - 29(2017), 2 vom: 21., Seite 81-86 |
| Sprache: |
Spanisch |
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| Weiterer Titel: |
Nomograma para predecir mal pronóstico en pacientes procedentes de urgencias con sepsis y bajo riesgo de daño orgánico evaluado mediante SOFA |
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| Beteiligte Personen: |
García-Villalba, Eva [VerfasserIn] |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 12.07.2018 Date Revised 09.04.2022 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM274983265 |
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| 100 | 1 | |a García-Villalba, Eva |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Nomogram to predict a poor outcome in emergency patients with sepsis and at low risk of organ damage according to Sepsis-related Organ Failure Assessment (SOFA) |
| 246 | 3 | 3 | |a Nomograma para predecir mal pronóstico en pacientes procedentes de urgencias con sepsis y bajo riesgo de daño orgánico evaluado mediante SOFA |
| 264 | 1 | |c 2017 | |
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| 500 | |a Date Completed 12.07.2018 | ||
| 500 | |a Date Revised 09.04.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: To develop a nomograph to predict a poor outcome (death during hospitalization or a hospital stay longer than 15 days) in emergency patients with sepsis and at low risk of organ damage according to Sepsis-related Organ Failure Assessment (SOFA) | ||
| 520 | |a MATERIAL AND METHODS: Prospective, observational study carried out in a single universitary hospital. All patients admitted from the emergency department with sepsis and SOFA scores of 6 or lower were enrolled. We used bivariate logistic regression analysis to develop a predictive nomogram | ||
| 520 | |a RESULTS: A total of 174 patients were included. Seventeen patients (9.8%) died during hospitalization and the average hospital stay was greater than 15 days in 29 (16.7%) patient. The outcome was poor in a total of 42 patients (24.1%);. Independent variables that were significantly associated with a poor outcome were SOFA score (odds ratio [OR], 1.3; 95% CI, 1.06-1.71; P<.05), C-reactive protein (CRP) concentration (OR, 1.04; 95% CI, 1.0-1.09; P<.05), N-terminal fragment of brain natriuretic peptide (NT-proBNP) concentration over 1330 ng/mL (OR, 2.64; 95% CI, 1.17-6.22; P<.05), and septic shock (OR, 8.3; 95% CI, 1.16-166.5; P<.05). For a SOFA score of 2 or more the crude OR was 4.44 (95%, CI, 1.91-10.34) and the OR adjusted for other variables was 3.08 (95% CI, 1.24-7.69) | ||
| 520 | |a CONCLUSION: A high percentage of patients predicted to be at low risk of organ failure had poor outcomes, associated with SOFA score, the presence of septic shock, CRP concentration, and elevated NT-proBNP concentration. The SOFA score by itself is an inadequate prognostic tool in patients at low risk of organ damage. Other clinical and analytical variables are required to complement the SOFA score | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Mal pronóstico | |
| 650 | 4 | |a Poor prognosis | |
| 650 | 4 | |a Predicción | |
| 650 | 4 | |a Prediction | |
| 650 | 4 | |a Sepsis | |
| 700 | 1 | |a Cano-Sánchez, Alfredo |e verfasserin |4 aut | |
| 700 | 1 | |a Alcaraz-García, Antonia |e verfasserin |4 aut | |
| 700 | 1 | |a Cinesi-Gómez, César |e verfasserin |4 aut | |
| 700 | 1 | |a Piñera-Salmerón, Pascual |e verfasserin |4 aut | |
| 700 | 1 | |a Marín, Irene |e verfasserin |4 aut | |
| 700 | 1 | |a Muñoz, Ángeles |e verfasserin |4 aut | |
| 700 | 1 | |a Vicente Vera, Tomás |e verfasserin |4 aut | |
| 700 | 1 | |a Bernal-Morell, Enrique |e verfasserin |4 aut | |
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