Sequential Organ Failure Assessment in H1N1 pandemic planning*

Shahpori, Reza; Stelfox, Henry T.; Doig, Christopher J.; Boiteau, Paul; Zygun, David

doi:10.1097/ccm.0b013e318206d548

Cited by 45 publications

(31 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Third, the mortality rates of our patients were somewhat higher compared with those in previous studies of patients with AKI treated with CRRT [27]. However, Allegretti et al .…”

Section: Discussioncontrasting

confidence: 57%

The benefit of specialized team approaches in patients with acute kidney injury undergoing continuous renal replacement therapy: propensity score matched analysis

Lee

Kim

et al. 2014

Crit Care

View full text Add to dashboard Cite

IntroductionContinuous renal replacement therapy (CRRT) has been widely used in critically ill acute kidney injury (AKI) patients. Moreover, some centers operate a specialized CRRT team (SCT) composed of physicians and nurses, but few studies have yet determined the superiority of SCT control.MethodsA total of 334 among 534 patients in the original cohort, who started CRRT for severe AKI between August 2007 and September 2009 in Yonsei University Health System and were matched with a propensity score (PS), were divided into two groups based on SCT application. Moreover, we compared CRRT-related outcomes including down-time per day and lost time per filter-exchange between the two groups. The primary outcomes were 28- and 90-day all-cause mortality, and the secondary outcomes were the rates of renal function recovery at 28- and 90-day.ResultsThe down-time per day, lost time per filter-exchange, and red blood cell-transfused numbers during CRRT treatment were significantly lower after SCT approach compared with the group before SCT, while net ultrafiltration rate in the after SCT group was significantly higher compared to the before SCT group. During the study period, the 28- and 90-day all-cause mortality rates were significantly decreased after SCT application. Cox regression analysis revealed that 28- and 90-day all-cause mortality rates were significantly lower under SCT control, after adjusting for primary diagnosis, emergent surgical cases, Charlson Comorbidity Index and biochemical parameters. However, there were no significant differences in the rate of renal function recovery before and after SCT approach in CRRT.ConclusionsA well-organized CRRT team could be beneficial for clinical outcomes through improving quality of care in AKI patients requiring CRRT treatment in the ICU.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-014-0454-8) contains supplementary material, which is available to authorized users.

show abstract

“…Third, the mortality rates of our patients were somewhat higher compared with those in previous studies of patients with AKI treated with CRRT [27]. However, Allegretti et al .…”

Section: Discussioncontrasting

confidence: 57%

The benefit of specialized team approaches in patients with acute kidney injury undergoing continuous renal replacement therapy: propensity score matched analysis

Lee

Kim

et al. 2014

Crit Care

View full text Add to dashboard Cite

show abstract

“…Similarly, this finding may be relevant to applications of the SOFA score to questions of ICU triage. 19,49–51 …”

Section: Discussionmentioning

confidence: 99%

Glasgow Coma Scale score dominates the association between admission Sequential Organ Failure Assessment score and 30-day mortality in a mixed intensive care unit population

Knox

Lanspa

Pratt

et al. 2014

Journal of Critical Care

View full text Add to dashboard Cite

OBJECTIVE The Sequential Organ Failure Assessment (SOFA) score, a measure of multiple organ dysfunction syndrome (MODS), is used to predict mortality in critically ill patients by assigning equally weighted scores across six different organ systems. We hypothesized that specific organ systems would have a greater association with mortality than others. DESIGN We retrospectively studied patients admitted over a period of 4.2 years to a mixedprofile intensive care unit (ICU). We recorded age and comorbidities, and calculated SOFA organ scores. The primary outcome was 30-day all-cause mortality. We determined which organ sub-scores of the SOFA score were most associated with mortality using multiple analytic methods: random forests, conditional inference trees, distanced-based clustering techniques, and logistic regression. SETTING A 24-bed mixed-profile adult ICU that cares for medical, surgical, and trauma (Level 1) patients at an academic referral center. PATIENTS All patients’ first admission to the study ICU during the study period. MEASUREMENTS AND MAIN RESULTS We identified 9,120 first admissions during the study period. Overall 30-day mortality was 12%. Multiple analytical methods all demonstrated that the best initial prediction variables were age and the central nervous system (CNS) SOFA subscore, which is determined solely by Glasgow Coma Scale score. CONCLUSIONS In a mixed population of critically ill patients, the Glasgow Coma Scale score dominates the association between admission SOFA score and 30-day mortality. Future research into outcomes from multiple organ dysfunction may benefit from new models for measuring organ dysfunction with special attention to neurologic dysfunction.

show abstract

“…An important caveat to the use of SOFA scores is that the mortality associated with a particular score may vary depending on the type of disease process. This fact was illustrated during the H1N1 influenza outbreak, during which a SOFA score of 11 only resulted in a mortality rate of 59 %, not the predicted 90 % mortality [44].…”

Section: Resource Allocationmentioning

confidence: 94%

Disaster Planning for the Intensive Care Unit: A Critical Framework

Jamieson

Biddison²

2014

The Organization of Critical Care

View full text Add to dashboard Cite

Safe and efficient delivery of critical care during disasters is a complex endeavor that requires meticulous planning. Development of an initial plan should take an "all-hazards" approach, building a basic plan that covers all disaster types. Planners can then use a hazard-vulnerability analysis (HVA) to focus more specific planning on those disaster types for which a given health system, hospital, or intensive care unit is at greatest risk. Plans should incorporate three equally important areas: the availability and use of physical space, hospital resources (supplies and equipment) both on site and readily available, and staffing concerns. Potential need for evacuation should also be addressed. Horizontal (within hospital) and vertical (complete) evacuation planning should also be undertaken. Finally, disaster plans should include guidance for the allocation of scarce healthcare resources if all surge capacity is exhausted and evacuation is not possible. Scarce resource allocation planning is essential to maximizing the likelihood that limited resources will be distributed in a fair and transparent way during a crisis. Disasters create a myriad of challenges for healthcare delivery. Careful planning can mitigate the potential harms to patients in such situations and provide a structure for delivering safe, efficient care in spite of those challenges.

show abstract

Sequential Organ Failure Assessment in H1N1 pandemic planning*

Cited by 45 publications

References 11 publications

The benefit of specialized team approaches in patients with acute kidney injury undergoing continuous renal replacement therapy: propensity score matched analysis

The benefit of specialized team approaches in patients with acute kidney injury undergoing continuous renal replacement therapy: propensity score matched analysis

Glasgow Coma Scale score dominates the association between admission Sequential Organ Failure Assessment score and 30-day mortality in a mixed intensive care unit population

Disaster Planning for the Intensive Care Unit: A Critical Framework

Contact Info

Product

Resources

About