Risk Factors for Sepsis Based on Sepsis-3 Criteria after Orthotopic Liver Transplantation

Wang, Yanling; Gu, Yu; Huang, Fei; Liu, Dezhao; Zhang, Zheng; Zhou, Niman; Liang, Jiani; Lu, Changyin; Yuan, Ding; Hei, Ziqing

doi:10.1155/2018/8703172

Cited by 14 publications

(18 citation statements)

References 26 publications

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“…In septic patients there is a similar problem: in some cases sepsis was the reason for admission, while in other cases sepsis developed during the course of hospital stay, possibly in postoperative patients (Sidhu et al, 2015;Wang et al, 2018). In such a case, sepsis cannot be predicted at the time of admission and thus at the time of data collection.…”

Section: Comparison Of the Scores Recorded At The Time Of The C-reactmentioning

confidence: 99%

Comparison of pediatric scoring systems for mortality in septic patients and the impact of missing information on their predictive power: a retrospective analysis

Niederwanger

Varga

Hell

et al. 2020

PeerJ

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Background Scores can assess the severity and course of disease and predict outcome in an objective manner. This information is needed for proper risk assessment and stratification. Furthermore, scoring systems support optimal patient care, resource management and are gaining in importance in terms of artificial intelligence. Objective This study evaluated and compared the prognostic ability of various common pediatric scoring systems (PRISM, PRISM III, PRISM IV, PIM, PIM2, PIM3, PELOD, PELOD 2) in order to determine which is the most applicable score for pediatric sepsis patients in terms of timing of disease survey and insensitivity to missing data. Methods We retrospectively examined data from 398 patients under 18 years of age, who were diagnosed with sepsis. Scores were assessed at ICU admission and re-evaluated on the day of peak C-reactive protein. The scores were compared for their ability to predict mortality in this specific patient population and for their impairment due to missing data. Results PIM (AUC 0.76 (0.68–0.76)), PIM2 (AUC 0.78 (0.72–0.78)) and PIM3 (AUC 0.76 (0.68–0.76)) scores together with PRSIM III (AUC 0.75 (0.68–0.75)) and PELOD 2 (AUC 0.75 (0.66–0.75)) are the most suitable scores for determining patient prognosis at ICU admission. Once sepsis is pronounced, PELOD 2 (AUC 0.84 (0.77–0.91)) and PRISM IV (AUC 0.8 (0.72–0.88)) become significantly better in their performance and count among the best prognostic scores for use at this time together with PRISM III (AUC 0.81 (0.73–0.89)). PELOD 2 is good for monitoring and, like the PIM scores, is also largely insensitive to missing values. Conclusion Overall, PIM scores show comparatively good performance, are stable as far as timing of the disease survey is concerned, and they are also relatively stable in terms of missing parameters. PELOD 2 is best suitable for monitoring clinical course.

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Section: Comparison Of the Scores Recorded At The Time Of The C-reactmentioning

confidence: 99%

Comparison of pediatric scoring systems for mortality in septic patients and the impact of missing information on their predictive power: a retrospective analysis

Niederwanger

Varga

Hell

et al. 2020

PeerJ

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“…Hypercalcemia may increase the incidence of infection or accelerate infection-related fatality. A previous longitudinal study showed that hypercalcemia was a risk factor for sepsis in critically ill patients 19 . Multiple studies have shown that patients on calcium channel blocker therapy were more likely to survive than patients without calcium channel blocker therapy under critical illness conditions 20 .…”

Section: Discussionmentioning

confidence: 97%

Increased Risk of Infection-Related and All-Cause Death in Hypercalcemic Patients Receiving Hemodialysis: The Q-Cohort Study

Yamada

Arase

Tokumoto

et al. 2020

Sci Rep

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Although hypercalcemia is a risk factor for all-cause mortality in hemodialysis patients, it remains unknown whether hypercalcemia increases the risk of infection-related death. A total of 2869 hemodialysis patients registered in the Q-cohort Study, a multicenter, prospective cohort study of hemodialysis patients, were analyzed. the predictor was albumin-corrected serum calcium level at baseline. the main outcome was infection-related death. Death risk were estimated by multivariableadjusted cox proportional hazard risk models and competing risk models. During the follow-up period of 4 years, 107 patients died of infection and 473 died of any cause. The patients were divided into four groups by the serum calcium level at baseline (G1, 5.7-8.9 mg/dL; G2, 9.0-9.4 mg/dL; G3, 9.5-9.9 mg/L; G4 10.0-16.5 mg/dL). In the multivariable-adjusted model, the incidence of infection-related death was significantly higher in the highest serum calcium group (G4) compared with the lowest serum calcium group (G1): hazard ratio [95% confidence interval], 2.34 [1.35-4.04], P = 0.002. Furthermore, higher serum calcium level was significantly associated with increased risk of all-cause death. In conclusion, our data suggest that a higher serum calcium level may be a risk factor for infection-related and all-cause death in hemodialysis patients.

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“…The leading cause of late death (>30 days) in SOT patients is related to infection and sepsis . Similarly, survival in patients who develop sepsis during pre‐, peri‐ and post‐orthotopic liver transplants is known to be lower compared with patients who do not develop sepsis …”

Section: Introductionmentioning

confidence: 99%

“…1 Similarly, survival in patients who develop sepsis during pre-, peri-and post-orthotopic liver transplants is known to be lower compared with patients who do not develop sepsis. 2 Risk factors for sepsis in SOT recipients are unique compared with the non-SOT population. 3,4 Early recognition of sepsis could be challenging because clinical findings could be attenuated with prolonged and indolent course of the disease.…”

Section: Introductionmentioning

confidence: 99%

Sepsis outcomes in solid organ transplant recipients

Gotur

Masud

Ezeana

et al. 2019

Transplant Infectious Dis

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Background We present data on a cohort of patients diagnosed with sepsis over a 10‐year period comparing outcomes in solid organ transplant (SOT) and non–solid organ transplant (non–SOT) recipients. Methods This is a retrospective single‐center study of patients with diagnosis of sepsis from 1/1/06 to 6/30/16. Cases and controls were matched by year of sepsis diagnosis with propensity score matching. Conditional logistic regression and repeated measurement models were performed for binary outcomes. Trends over time for in‐hospital mortality were determined using the Cochran‐Armitage test. A gamma‐distributed model was performed on the continuous variables. Results Overall, there were 18 632 admission encounters with a discharge diagnosis of sepsis in 14 780 unique patients. Of those admissions, 1689 were SOT recipients. After 1:1 matching by year, there were three thousand three hundred and forty patients (1670 cases; 1670 controls) diagnosed with sepsis. There was a decreasing trend for in‐hospital mortality for sepsis over time in SOT patients and non–SOT patients (P < .05) due to early sepsis recognition and improved standard of care. Despite higher comorbidities in the SOT group, conditional logistic regression showed that in‐hospital mortality for sepsis in SOT patients was similar compared with non–SOT patients (odds ratio [OR] =1.14 [95% confidence interval {CI}, 0.95‐1.37], P = .161). However, heart and lung SOT subgroups had higher odds of dying compared with the non–SOT group (OR = 1.83 [95% CI, 1.30‐2.57], P < .001 and OR = 1.77 [95% CI, 1.34‐2.34], P < .001). On average, SOT patients had 2 days longer hospital length of stay compared with non–SOT admissions (17.00 ± 19.54 vs 15.23 ± 17.07, P < .05). Additionally, SOT patients had higher odds of hospital readmission within 30 days (OR = 1.25 [95% CI, 1.06‐1.51], P = .020), and higher odds for DIC compared with non–SOT patients (OR = 1.76 [95% CI, 1.10‐2.86], P = .021). Conclusion Sepsis in solid organ transplants and non–solid organ transplant patients have similar mortality; however, the subset of heart and lung transplant recipients with sepsis has a higher rate of mortality compared with the non–solid organ transplant recipients. SOT with sepsis as a group has a higher hospital readmission rate compared with non–transplant sepsis patients.

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Risk Factors for Sepsis Based on Sepsis-3 Criteria after Orthotopic Liver Transplantation

Cited by 14 publications

References 26 publications

Comparison of pediatric scoring systems for mortality in septic patients and the impact of missing information on their predictive power: a retrospective analysis

Comparison of pediatric scoring systems for mortality in septic patients and the impact of missing information on their predictive power: a retrospective analysis

Increased Risk of Infection-Related and All-Cause Death in Hypercalcemic Patients Receiving Hemodialysis: The Q-Cohort Study

Sepsis outcomes in solid organ transplant recipients

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