Prognostic scores for early stratification of septic patients admitted to an emergency department-high dependency unit

Innocenti, Francesca; Bianchi, S.; Guerrini, Elisa; Vicidomini, Sonia; Conti, Alberto; Zanobetti, Maurizio; Pini, Riccardo

doi:10.1097/mej.0000000000000075

Cited by 57 publications

(33 citation statements)

References 12 publications

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“…ICU patients develop a degree of inflammatory response, whether or not they have infection, limiting the accuracy of clinical and laboratory tests (Peters et al, 2004;Pierrakos and Vincent, 2010;Ryan and Levy, 2003). In our study, SAPS II and SOFA score as well as CRP had low sensitivity and specificity for the diagnosis of sepsis, even though SAPS II and SOFA score retain their accuracy in predicting mortality, findings that correlate with previous ones (Clyne and Olshaker, 1999;Innocenti et al, 2013;Pierrakos and Vincent, 2010;Povoa et al, 2005).…”

Section: Discussioncontrasting

confidence: 68%

Role of CD64 expression on neutrophils in the diagnosis of sepsis and the prediction of mortality in adult critically ill patients

Papadimitriou-Olivgeris

Lekka

Zisimopoulos

et al. 2015

Diagnostic Microbiology and Infectious Disease

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Section: Discussioncontrasting

confidence: 68%

Role of CD64 expression on neutrophils in the diagnosis of sepsis and the prediction of mortality in adult critically ill patients

Papadimitriou-Olivgeris

Lekka

Zisimopoulos

et al. 2015

Diagnostic Microbiology and Infectious Disease

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“…However, only 3 studies used TnT values 2. By contrast, other investigators have failed to validate troponin as an independent predictor of mortality in addition to severity of illness scores 9, 27, 28, 29…”

Section: Discussionmentioning

confidence: 99%

Role of Admission Troponin‐T and Serial Troponin‐T Testing in Predicting Outcomes in Severe Sepsis and Septic Shock

Vallabhajosyula

Sakhuja

Geske

et al. 2017

JAHA

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BackgroundTroponin‐T elevation is seen commonly in sepsis and septic shock patients admitted to the intensive care unit. We sought to evaluate the role of admission and serial troponin‐T testing in the prognostication of these patients.Methods and ResultsThis was a retrospective cohort study from 2007 to 2014 on patients admitted to the intensive care units at the Mayo Clinic with severe sepsis and septic shock. Elevated admission troponin‐T and significant delta troponin‐T were defined as ≥0.01 ng/mL and ≥0.03 ng/mL in 3 hours, respectively. The primary outcome was in‐hospital mortality. Secondary outcomes included 1‐year mortality and lengths of stay. During this 8‐year period, 944 patients met the inclusion criteria with 845 (90%) having an admission troponin‐T ≥0.01 ng/mL. Serial troponin‐T values were available in 732 (78%) patients. Elevated admission troponin‐T was associated with older age, higher baseline comorbidity, and severity of illness, whereas significant delta troponin‐T was associated with higher severity of illness. Admission log10 troponin‐T was associated with unadjusted in‐hospital (odds ratio 1.6; P=0.003) and 1‐year mortality (odds ratio 1.3; P=0.04), but did not correlate with length of stay. Elevated delta troponin‐T and log10 delta troponin‐T were not significantly associated with any of the primary or secondary outcomes. Admission log10 troponin‐T remained an independent predictor of in‐hospital mortality (odds ratio 1.4; P=0.04) and 1‐year survival (hazard ratio 1.3; P=0.008).ConclusionsIn patients with sepsis and septic shock, elevated admission troponin‐T was associated with higher short‐ and long‐term mortality. Routine serial troponin‐T testing did not add incremental prognostic value in these patients.

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“…Intensive and sub-intensive care beds are limited in our reality; therefore, between Emergency Room and ICU, we created an area where critical patients could be managed and stabilised for 24-48 h, in order to avoid ICU admission. In a population of patients with sepsis, we recently demonstrated that ED-HDU allows a significant reduction in ICU admissions, leading to a relevant costsaving [9].…”

Section: Setting and Study Populationmentioning

confidence: 99%

Quality of life after mild to moderate trauma

Innocenti

Taglia

Coppa

et al. 2015

Injury

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Prognostic scores for early stratification of septic patients admitted to an emergency department-high dependency unit

Cited by 57 publications

References 12 publications

Role of CD64 expression on neutrophils in the diagnosis of sepsis and the prediction of mortality in adult critically ill patients

Role of CD64 expression on neutrophils in the diagnosis of sepsis and the prediction of mortality in adult critically ill patients

Role of Admission Troponin‐T and Serial Troponin‐T Testing in Predicting Outcomes in Severe Sepsis and Septic Shock

Quality of life after mild to moderate trauma

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