A prospective validation of Sepsis-3 guidelines in acute hepatobiliary sepsis: qSOFA lacks sensitivity and SIRS criteria lacks specificity (Cohort Study)

Mak, Malcolm Han Wen; Low, Jee Keem; Junnarkar, Sameer P; Huey, Terence; Shelat, Vishal G

doi:10.1016/j.ijsu.2019.10.022

Cited by 18 publications

(30 citation statements)

References 31 publications

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“…Complicated AA is associated with delayed presentation or diagnosis and treatment. Delayed presentation is associated with inferior outcomes in acute care surgery [22][23][24][25]. However, the outcomes of DDA patients in our experience are not inferior.…”

Section: Discussionmentioning

confidence: 55%

Diverticular Disease of the Appendix Is Associated with Complicated Appendicitis

Chia

Chan

Shelat

2020

GE Port J Gastroenterol

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Introduction: Diverticular disease of the vermiform appendix (DDA) has an incidence of 0.004 to 2.1% in appendicectomy specimens. DDA is variably associated with perforation and malignancy. We report a single-center experience of DDA. The primary aim is to validate the association of DDA with complicated appendicitis or malignancy, and the secondary aim is to validate systemic inflammatory response syndrome (SIRS) criteria and quick Sepsis-related Organ Failure Assessment (qSOFA) scores. Methods: The histopathology reports of 2,305 appendicectomy specimens from January 2011 to December 2015 were reviewed. Acute appendicitis was found in 2,164 (93.9%) specimens. Histology of the remaining 141 (6.1%) patients revealed: normal appendix (n = 110), DDA (n = 22), endometriosis of appendix (n = 6), and an absent appendix (n = 3). Patient demographics, clinical profile, operative data, and perioperative outcomes of DDA patients are studied. Modified Alvarado score, Andersson score, SIRS criteria, and qSOFA scores were retrospectively calculated. Results: The incidence of DDA was 0.95%. Ten patients (45.5%) had diverticulitis. The mean age of DDA patients was 39.5 years (range 23–87), with male preponderance (n = 12, 54.5%). The median Modified Alvarado score was 8 (range 4–9), and the median Andersson score was 5 (range 2–8). Fourteen patients (63.6%) had SIRS, and none had a high qSOFA score. Eight patients (36.4%) had complicated appendicitis (perforation [n = 2] or abscess [n = 6]). Eleven (50%) patients underwent laparoscopic appendicectomy. There were three 30-day readmissions and no mortality. Conclusion: DDA is a distinct clinical pathology associated with complicated appendicitis.

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Section: Discussionmentioning

confidence: 55%

Diverticular Disease of the Appendix Is Associated with Complicated Appendicitis

Chia

Chan

Shelat

2020

GE Port J Gastroenterol

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“…The mean GIF score for the first three days was better than the GIF score on the first day for evaluating the gastrointestinal function of children with TBI. One limitation of this study is that the SOFA score may be inapplicable to young infants and toddlers in terms of the items assessed [25][26][27]. The PCIS fully integrates the physiological and morbidity characteristics of children at different ages and was introduced to predict the risk of death [28,29].…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal failure score in children with traumatic brain injury

Zhou

Tang

2021

BMC Pediatr

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Background To review the value of the gastrointestinal failure (GIF) score in children with different degrees of traumatic brain injury (TBI) by analyzing the correlation between outcome and gastrointestinal function. Methods A total of 165 children with TBI who were diagnosed and treated in the surgical intensive care unit (SICU) for longer than 72 h between August 2017 and September 2019 were analyzed. Admission parameters included sex, age, Glasgow Coma Scale (GCS) score, body mass index (BMI), leukocyte count, C-reactive protein (CRP), hemoglobin (Hb), hematocrit (Hct), blood glucose, lactic acid, procalcitonin (PCT), albumin, plasma osmotic pressure, prothrombin time (PT) and activated partial thromboplastin time (APTT). To predict outcomes, the Pediatric Sequential Organ Failure Assessment (SOFA) score, Pediatric Clinical Illness Score (PCIS), and mean GIF score for the first three days were combined. Results The percentage of patients with gastrointestinal dysfunction on the first day was 78.8 %. Food intolerance (FI) and intra-abdominal hypertension (IAH) developed in 36.4 and 21.8 % of the patients, respectively. The GIF score and mean GIF score for the first three days were significantly different between children with different degrees of TBI (P < 0.05); these scores were also significantly different between patients who died and those who survived (P < 0.05). The mean GIF score for the first three days was identified as an independent risk factor for mortality (odds ratio > 1, 95 % confidence interval = 1.457 to 16.016, P < 0.01), as was the PCIS. Receiver operating characteristic (ROC) curve analysis suggested that the mean GIF score for the first three days had the same calibrating power as the PCIS in discriminating the risk of death of children. Conclusions The incidence of gastrointestinal dysfunction in children with TBI is high. The GIF score has the ability to reflect the status of the gastrointestinal system. The mean GIF score for the first three days has high prognostic value for ICU mortality in the SICU.

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“…The mean GIF score for the rst three days is better than the GIF score on the rst day for evaluating the gastrointestinal function of children with TBI. One limitation of this study is that the SOFA score may be inapplicable to young infants and toddlers in terms of the items assessed [25][26][27]. The PCIS fully integrates the physiological and morbidity characteristics of children at different ages, which were introduced to predict the risk of death [28,29].…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Failure Score in Children with Traumatic Brain Injury

Zhou

Lü

Tang³

2021

Preprint

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Purposes: To review the value of the gastrointestinal failure (GIF) score in children with different degrees of traumatic brain injury (TBI) by analyzing the correlation between outcome and gastrointestinal function. Methods: A total of 165 children with TBI who were diagnosed and treated in the surgical intensive care unit (SICU) for longer than 72 h between August 2017 and September 2019 were retrospectively analyzed. Admission parameters included sex, age, Glasgow Coma Scale (GCS) score, body mass index (BMI), leukocyte count, C-reactive protein (CRP), hemoglobin (Hb) and hematocrit (Hct), blood glucose, lactic acid, procalcitonin (PCT), albumin, plasma osmotic pressure, prothrombin time (PT) and activated partial thromboplastin time (APTT). To predict outcomes, the Sequential Organ Failure Assessment (SOFA) score, Pediatric Clinical Illness Score (PCIS), and mean GIF score for the first three days were combined. Results: The percent of patients with gastrointestinal dysfunction on the first day was 78.8%. Food intolerance (FI) and intra-abdominal hypertension (IAH) developed in 36.4% and 21.8% of the patients, respectively. The GIF score and mean GIF score for the first three days in children with different degrees of TBI were significantly different (P<0.05); these scores were also significantly different between patients who died and those who survived (P<0.05). The mean GIF score for the first three days was identified as an independent risk factor for mortality (odds ratio>1, 95% confidence interval=1.457 to 16.016, P<0.01), as was the PCIS. Receiver operating characteristic (ROC) curve analysis suggested that the mean GIF score for the first three days had the same calibrating power as the PCIS in discriminating the risk of death of children. Conclusion: The incidence of gastrointestinal dysfunction in children with TBI is high. The GIF score has the ability to reflect the status of the gastrointestinal system. The mean GIF score for the first three days has high prognostic value for ICU mortality in the SICU.

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A prospective validation of Sepsis-3 guidelines in acute hepatobiliary sepsis: qSOFA lacks sensitivity and SIRS criteria lacks specificity (Cohort Study)

Cited by 18 publications

References 31 publications

Diverticular Disease of the Appendix Is Associated with Complicated Appendicitis

Diverticular Disease of the Appendix Is Associated with Complicated Appendicitis

Gastrointestinal failure score in children with traumatic brain injury

Gastrointestinal Failure Score in Children with Traumatic Brain Injury

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