Scoring-Systeme auf der Intensivtherapiestation

Lewandowski, K.; Lewandowski, Monika

doi:10.1007/s00101-003-0550-7

Cited by 15 publications

(8 citation statements)

References 38 publications

(34 reference statements)

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“…As TISS-28 is a surrogate parameter for intensity of care, our results coincide with the findings that men receive more invasive procedures than do women, regardless of the reason of admission or procedures [7,8]. Conversely, TISS-28 was thought to be used to compare predicted survival in different populations [21,22]. Based on these findings, it might be difficult to use scoring systems not incorporating gender as an independent factor for ICU mortality.…”

Section: Discussionsupporting

confidence: 81%

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Gender-related outcome difference is related to course of sepsis on mixed ICUs: a prospective, observational clinical study

et al. 2011

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IntroductionImpact of gender on severe infections is in highly controversial discussion with natural survival advantage of females described in animal studies but contradictory to those described human data. This study aims to describe the impact of gender on outcome in mixed intensive care units (ICUs) with a special focus on sepsis.MethodsWe performed a prospective, observational, clinical trial at Charité University Hospital in Berlin, Germany. Over a period of 180 days, patients were screened, undergoing care in three mainly surgical ICUs. In total, 709 adults were included in the analysis, comprising the main population ([female] n = 309, [male] n = 400) including 327 as the sepsis subgroup ([female] n = 130, [male] n = 197).ResultsBasic characteristics differed between genders in terms of age, lifestyle factors, comorbidities, and SOFA-score (Sequential Organ Failure Assessment). Quality and quantity of antibiotic therapy in means of antibiotic-free days, daily antibiotic use, daily costs of antibiotics, time to antibiotics, and guideline adherence did not differ between genders. ICU mortality was comparable in the main population ([female] 10.7% versus [male] 9.0%; P = 0.523), but differed significantly in sepsis patients with [female] 23.1% versus [male] 13.7% (P = 0.037). This was confirmed in multivariate regression analysis with OR = 1.966 (95% CI, 1.045 to 3.701; P = 0.036) for females compared with males.ConclusionsNo differences in patients' outcome were noted related to gender aspects in mainly surgical ICUs. However, for patients with sepsis, an increase of mortality is related to the female sex.

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Section: Discussionsupporting

confidence: 81%

“…However, primary assessed scores reflect only the moment of admission but not the kinetic of clinical course, for which SOFA is not validated [20]. Because this scoring system does not take gender into account [21,22], the gender-related difference in mortality is not reflected well and remains a topic that must be elucidated.…”

Section: Discussionmentioning

confidence: 99%

Gender-related outcome difference is related to course of sepsis on mixed ICUs: a prospective, observational clinical study

et al. 2011

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“…There has been a great advancement recently in developing various models to measure severity of critically ill patients and to predict their mortality. Several models like APACHE II, SAP and SOFA have been devised for mortality prediction in critical ill patients 1. The evaluation of quality of intensive care can be effectively determined only by those scoring model which quantify the severity of illness 2-5.…”

Section: Introductionmentioning

confidence: 99%

Better prognostic marker in ICU - APACHE II, SOFA or SAP II!

Naqvi¹,

Mahmood²,

Ziaullaha³

et al. 2016

Pak J Med Sci

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Objectives:This study was designed to determine the comparative efficacy of different scoring system in assessing the prognosis of critically ill patients.Methods:This was a retrospective study conducted in medical intensive care unit (MICU) and high dependency unit (HDU) Medical Unit III, Civil Hospital, from April 2012 to August 2012. All patients over age 16 years old who have fulfilled the criteria for MICU admission were included. Predictive mortality of APACHE II, SAP II and SOFA were calculated. Calibration and discrimination were used for validity of each scoring model.Results:A total of 96 patients with equal gender distribution were enrolled. The average APACHE II score in non-survivors (27.97+8.53) was higher than survivors (15.82+8.79) with statistically significant p value (<0.001). The average SOFA score in non-survivors (9.68+4.88) was higher than survivors (5.63+3.63) with statistically significant p value (<0.001). SAP II average score in non-survivors (53.71+19.05) was higher than survivors (30.18+16.24) with statistically significant p value (<0.001).Conclusion:All three tested scoring models (APACHE II, SAP II and SOFA) would be accurate enough for a general description of our ICU patients. APACHE II has showed better calibration and discrimination power than SAP II and SOFA.

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“…Both can help to explain the higher mortality rate in these patients. In contrast to established scoring methods such as APACHE 2, SAPS 2 and SOFA, the score shown here does not describe a course over 24 h but can rather be used at the bedside within a very short time and, thus, describes early septic shock [13][14][15][16]. We performed survival analyses for the first 7 days and at day 56.…”

Section: Discussionmentioning

confidence: 99%

First Evaluation of a New Dynamic Scoring System Intended to Support Prescription of Adjuvant CytoSorb Hemoadsorption Therapy in Patients with Septic Shock

Kogelmann¹,

Hübner

Schwameis

et al. 2021

JCM

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Introduction: Despite advances in critical care medicine, adjunctive approaches in sepsis therapy have failed to prove their efficacy. Notwithstanding promising results using hemoadsorption (CytoSorb), questions remain concerning timing and dosing. We created a dynamic scoring system (DSS) to assess patients with early septic shock and performed a first evaluation of the system in this patient population. Methods: Data from 502 patients with septic shock according to Sepsis-3 criteria were retrospectively analyzed. Score parameters were documented at the time of diagnosis (T0) and 6 h later (T6) to calculate a dynamic score. Survival on day 7 and 56 as well as ICU and hospital mortality were analyzed in regard to the score as well as the delay of hemoadsorption therapy. Results: Of the 502 patients analyzed, 198 received adjunctive CytoSorb treatment and 304 received standard therapy. Septic shock was typically represented by 5 points, while >6 points indicated a situation refractory to standard therapy with the worst outcome in patients shown by >8 points. The differences in mortality between the score groups (<6, 6–8, >8 points) were significant. Analysis further showed a significant 56-day, ICU and hospital survival advantage in CytoSorb patients when therapy was started early. Conclusion: We created a scoring system allowing for the assessment of the clinical development of patients in the early phase of septic shock. Applying this approach, we were able to detect populations with a distinct mortality pattern. The data also showed that an early start of CytoSorb therapy was associated with significantly improved survival. As a next step, this easy-to-apply scoring system would require validation in a prospective manner to learn whether patients to be treated with hemoadsorption therapy in the course of septic shock could thereby be identified.

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Scoring-Systeme auf der Intensivtherapiestation

Cited by 15 publications

References 38 publications

Gender-related outcome difference is related to course of sepsis on mixed ICUs: a prospective, observational clinical study

Gender-related outcome difference is related to course of sepsis on mixed ICUs: a prospective, observational clinical study

Better prognostic marker in ICU - APACHE II, SOFA or SAP II!

First Evaluation of a New Dynamic Scoring System Intended to Support Prescription of Adjuvant CytoSorb Hemoadsorption Therapy in Patients with Septic Shock

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