Does prediction of outcome alter patient management?

Murray, Lauren; Teasdale, Graham M.; Jennett, Bryan; Kelly, D.; Murray, Gordon; Miller, Jay D.; Jones, Patricia A.; Pickard, John D.; Bailey, S; Shaw, M. D. M.; Achilles, J.; Lacey, J L

doi:10.1016/0140-6736(93)90631-p

Cited by 132 publications

(54 citation statements)

References 19 publications

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“…Especially in patients with moderately elevated SAPS II scores, the additional determination of MRproANP markedly improves risk stratification. Prompt risk stratification has been shown to influence patient management, decrease costs and potentially improve clinical outcome [57][58][59][60]. However, clinical impact and costs, particularly with regard to new biomarkers, need to be addressed in future studies.…”

Section: Combination Of Mr-proanp Pct and Icu Scoresmentioning

confidence: 99%

Midregional pro-atrial natriuretic peptide and procalcitonin improve survival prediction in VAP

Boeck¹,

Eggimann²,

Smyrnios³

et al. 2010

European Respiratory Journal

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Ventilator-associated pneumonia (VAP) affects mortality, morbidity and cost of critical care. Reliable risk estimation might improve end-of-life decisions, resource allocation and outcome. Several scoring systems for survival prediction have been established and optimised over the last decades. Recently, new biomarkers have gained interest in the prognostic field. We assessed whether midregional pro-atrial natriuretic peptide (MR-proANP) and procalcitonin (PCT) improve the predictive value of the Simplified Acute Physiologic Score (SAPS) II and Sequential Related Organ Failure Assessment (SOFA) in VAP.Specified end-points of a prospective multinational trial including 101 patients with VAP were analysed. Death ,28 days after VAP onset was the primary end-point.MR-proANP and PCT were elevated at the onset of VAP in nonsurvivors compared with survivors (p50.003 and p50.017, respectively) and their slope of decline differed significantly (p50.018 and p50.039, respectively). Patients with the highest MR-proANP quartile at VAP onset were at increased risk for death (log rank p50.013). In a logistic regression model, MR-proANP was identified as the best predictor of survival. Adding MR-proANP and PCT to SAPS II and SOFA improved their predictive properties (area under the curve 0.895 and 0.880).We conclude that the combination of two biomarkers, MR-proANP and PCT, improve survival prediction of clinical severity scores in VAP.

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Section: Combination Of Mr-proanp Pct and Icu Scoresmentioning

confidence: 99%

Midregional pro-atrial natriuretic peptide and procalcitonin improve survival prediction in VAP

Boeck¹,

Eggimann²,

Smyrnios³

et al. 2010

European Respiratory Journal

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show abstract

“…In additional to, we think that the predictor models have to be used only informing to patients and their relationships, understanding of HI severity and never make a negative effect on patients' treatment (20).…”

Section: Discussionmentioning

confidence: 99%

Homocystein Levels in Migraine Patients

Sari¹,

Hiz²,

Bilge³

et al. 2011

JAREM

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“…It is a truism supported by evidence that prognosis is the cornerstone of medical decision-making [3]. Nowhere is this maxim more apparent than in the patient with a devastating brain injury.…”

Section: Improving Prognostic Accuracymentioning

confidence: 99%

Observations on Ethical Issues in the Neuro-ICU

Bernat

2015

Neurocrit Care

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Does prediction of outcome alter patient management?

Cited by 132 publications

References 19 publications

Midregional pro-atrial natriuretic peptide and procalcitonin improve survival prediction in VAP

Midregional pro-atrial natriuretic peptide and procalcitonin improve survival prediction in VAP

Homocystein Levels in Migraine Patients

Observations on Ethical Issues in the Neuro-ICU

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