Cohort study of the APACHE II score and mortality for different types of intensive care unit patients

Sungono, Veli; Hariyanto, Hori; Soesilo, Tri Edhi Budhi; Adisasmita, Asri C.; Syarif, Syahrizal; Lukito, Antonia Anna; Widysanto, Allen; Puspitasari, Vivien; Tampubolon, Oloan E.; Sutrisna, Bambang; Sudaryo, Mondastri Korib

doi:10.1136/postgradmedj-2021-140376

Cited by 16 publications

(11 citation statements)

References 16 publications

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“…The predictive value of the baseline lactate level plus the APACHE II score was higher than that of the lactate clearance at 24 hrs, and the APACHE II score was more valuable than the lactate level at baseline for predicting the prognosis of critically ill patients with abnormal lactate levels. A clinical trial showed that the mortality rate increased as the APACHE II score increased, and the APACHE II score had a better value for predicting patient prognosis [36]. In this study, the results showed that although the AUC of the APACHE II score for predicting prognosis was higher (0.838), its sensitivity and specificity were somewhat poor (81.0 and 75.9%, respectively).…”

Section: Discussionmentioning

confidence: 54%

The combination of lactate level, lactate clearance and APACHE II score better predicts short-term outcomes in critically Ill patients: a retrospective cohort study

et al. 2022

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Background The mortality rate is high in critically ill patients due to the difficulty of diagnosis and treatment. Thus, it is very important to explore the predictive value of different indicators related to prognosis in critically ill patients. Methods This was a retrospective cohort study of patients in the intensive care unit (ICU) of the Sixth People’s Hospital in Shanghai, China. A total of 1465 ICU patients had lactate values > 2.1 mmol/L at least once within 24 h of ICU admission, and arterial blood gas was monitored more than twice during the ICU stay. Results The predictive value of lactate clearance at 24 h was not high, and the sensitivity and specificity were lower. The predictive value of the lactate level at baseline and the APACHE II score was higher than that of lactate clearance at 24 h in critically ill patients. The predictive value of the lactate level at baseline combined with the APACHE II score was higher than that of the lactate level at baseline or the APACHE II score alone. In addition, the predictive value of lactate clearance at 24 h combined with the APACHE II score was also significantly higher than that of lactate clearance at 24 h or the APACHE II score alone. In particular, the area under the ROC curve reached 0.900, the predictive value was markedly higher than that of the ROC alone, and the sensitivity and specificity were better when these three indicators were combined. Conclusions The combination of lactate level, lactate clearance and APACHE II score better predicts short-term outcomes in critically ill patients.

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Section: Discussionmentioning

confidence: 54%

The combination of lactate level, lactate clearance and APACHE II score better predicts short-term outcomes in critically Ill patients: a retrospective cohort study

et al. 2022

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“…However, APACHE II and SAPS II scoring predictions are very complex, requiring multiple variables to calculate their score ( 104 ). Their cut-offs, sensitivity, and specificity for predicting the mortality risk of ICU patients vary with patient populations ( 79 ). In addition, they are weak to measure organ dysfunction ( 105 ) and are affected by lead-time bias and treatment ( 106 , 107 ).…”

Section: Discussionmentioning

confidence: 99%

“…For the subgroup analysis of strains, we evaluated studies that used only Lactobacillus rhamnosus GG as probiotics and mixed strains as probiotics. Moreover, we divided the subgroups into highseverity of illness and low-severity illness groups according to the Acute Physiology And Chronic Health Evaluation (APACHE) II score of 20 at baseline or Simplified Acute Physiology Score (SPSA) II score of 35 at baseline (10,(79)(80)(81). According to the ROB results, the study was divided into high-quality (only low ROB) and low-quality (moderate and high ROB) groups.…”

Section: Subgroup Analysismentioning

confidence: 99%

Probiotic Supplementation Prevents the Development of Ventilator-Associated Pneumonia for Mechanically Ventilated ICU Patients: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials

Liu

Chen

et al. 2022

Front. Nutr.

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BackgroundVentilator-associated pneumonia (VAP) is one of the common critical complications of nosocomial infection (NI) in invasive mechanically ventilated intensive care unit (ICU) patients. The efficacy of total parenteral nutrition (TPN), enteral nutrition and/or adjuvant peripheral parenteral nutrition (EPN) supplemented with or without probiotic, prebiotic, and synbiotic therapies in preventing VAP among these patients has been questioned. We aimed to systematically and comprehensively summarize all available studies to generate the best evidence of VAP prevention for invasive mechanically ventilated ICU patients.MethodsRandomized controlled trials (RCTs) for the administration of TPN, EPN, probiotics-supplemented EPN, prebiotics-supplemented EPN, and synbiotics-supplemented EPN for VAP prevention in invasive mechanically ventilated ICU patients were systematically retrieved from four electronic databases. The incidence of VAP was the primary outcome and was determined by the random-effects model of a Bayesian framework. The secondary outcomes were NI, ICU and hospital mortality, ICU and hospital length of stay, and mechanical ventilation duration. The registration number of Prospero is CRD42020195773.ResultsA total of 8339 patients from 31 RCTs were finally included in network meta-analysis. The primary outcome showed that probiotic-supplemented EPN had a higher correlation with the alleviation of VAP than EPN in critically invasive mechanically ventilated patients (odds ratio [OR] 0.75; 95% credible intervals [CrI] 0.58–0.95). Subgroup analyses showed that probiotic-supplemented EPN prevented VAP in trauma patients (OR 0.30; 95% CrI 0.13–0.83), mixed probiotic strain therapy was more effective in preventing VAP than EPN therapy (OR 0.55; 95% CrI 0.31–0.97), and low-dose probiotic therapy (less than 1010 CFU per day) was more associated with lowered incidence of VAP than EPN therapy (OR 0.16; 95% CrI 0.04–0.64). Secondary outcomes indicated that synbiotic-supplemented EPN therapy was more significantly related to decreased incidence of NI than EPN therapy (OR 0.34; 95% CrI 0.11–0.85). Prebiotic-supplemented EPN administration was the most effective in preventing diarrhea (OR 0.05; 95% CrI 0.00–0.71).ConclusionProbiotic supplementation shows promise in reducing the incidence of VAP in critically invasive mechanically ventilated patients. Currently, low quality of evidence reduces strong clinical recommendations. Further high-quality RCTs are needed to conclusively prove these findings.Systamatic Review Registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020195773], identifier [CRD42020195773].

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“…Our research found that the expression level of TRIM7 in PBMCs of patients with non-septic-infection was lower than that of normal controls, while the expression level of TRIM7 in PBMCs of patients with sepsis was lower than that of patients with non-septic-infection. At the same time, the expression of TRIM7 was negatively correlated with disease severity scores including SOFA [ 27 ], APACHE II score [ 28 ], and inflammation-related indicators including WBC, CRP, PCT, TNF-α, and IL-6. The expression of TRIM7 in PBMCs of individuals with infection is closely related to its biological role in affecting inflammatory response through regulating the TLR4 pathway, and its change trend is consistent with the results of our previous cell experiments.…”

Section: Discussionmentioning

confidence: 99%

Study on the expression of TRIM7 in peripheral blood mononuclear cells of patients with sepsis and its early diagnostic value

Liu

et al. 2022

BMC Infect Dis

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Background The early diagnosis of sepsis is beneficial to put forward a reasonable clinical treatment plan as soon as possible. This study was to explore the expression of Tripartite Motif 7 (TRIM7) in peripheral blood mononuclear cells (PBMCs) of patients with sepsis and its diagnostic value. Methods This is a cross-sectional study. A total of 69 patients with infectious diseases were enrolled in the emergency room. They were divided into the sepsis group (34 cases) and the non-sepsis infection group (35 cases). There were 25 healthy subjects who were selected as the control group. The expression of TRIM7 in PBMCs was observed by immunofluorescence staining. The correlation between the expression of TRIM7 mRNA and acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT), tumor necrosis factor (TNF)-α and interleukin (IL)-6 was discussed. The receiver operating characteristic (ROC) curve was utilized for evaluating the value of TRIM7 expression for the early diagnosis of sepsis. Results The fluorescence intensity representing the expression level of TRIM7 in PBMCs of patients in the sepsis group was the lowest among three groups. The TRIM7 mRNA expression in PBMCs of the sepsis group was greatly decreased in comparison with that of the non-sepsis infection group and control group (P < 0.05). Spearman correlation analysis indicated that TRIM7 mRNA expression was negatively correlated with APACHE II score, SOFA score, WBC, CRP, PCT, TNF-α and IL-6. ROC curve analysis revealed that the area under curve (AUC) of TRIM7 mRNA expression in PBMCs for the diagnosis of sepsis was 0.798, with a 95% confidence interval of 0.691- 0.905, a sensitivity of 73.5%, and a specificity of 77.1%. Conclusion The expression of TRIM7 in PBMCs of patients with sepsis is significantly down-regulated, which has certain clinical value for early diagnosis of sepsis.

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Cohort study of the APACHE II score and mortality for different types of intensive care unit patients

Cited by 16 publications

References 16 publications

The combination of lactate level, lactate clearance and APACHE II score better predicts short-term outcomes in critically Ill patients: a retrospective cohort study

The combination of lactate level, lactate clearance and APACHE II score better predicts short-term outcomes in critically Ill patients: a retrospective cohort study

Probiotic Supplementation Prevents the Development of Ventilator-Associated Pneumonia for Mechanically Ventilated ICU Patients: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials

Study on the expression of TRIM7 in peripheral blood mononuclear cells of patients with sepsis and its early diagnostic value

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