Study of clinical course of organ dysfunction in intensive care

Doig, Christopher J.; Zygun, David; Fick, Gordon H.; Laupland, Kevin B.; Boiteau, Paul; Shahpori, Reza; Rosenal, Tom; Sandham, J. Dean

doi:10.1097/01.ccm.0000108881.14082.10

Cited by 35 publications

(27 citation statements)

References 33 publications

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“…10,[14][15][16][17]19,20 Many studies have shown that daily monitoring of organ dysfunction can be useful for estimating the response to therapy. [21][22][23] We believe that the model proposed in our study -to measure the PELOD score on days 1, 2, 5, 8, 12, 16 and 18 -provides the best balance between the workload of assessing daily scores and the optimal association with prognosis throughout the PICU stay.…”

Section: Discussionmentioning

confidence: 99%

“…14 The optimal period for measuring daily scores for multiple organ dysfunction in adults has been studied. [15][16][17] Indeed, trends in the Sequential Organ Failure Assessment score over the first 48 hours in the ICU was found to be a sensitive indicator of outcome, with decreasing scores associated with a decrease in mortality from 50% to 27%. 17 Similar data for critically ill children are lacking.…”

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confidence: 99%

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Daily estimation of the severity of multiple organ dysfunction syndrome in critically ill children

Leteurtre

Duhamel²,

Grandbastien³

et al. 2010

Canadian Medical Association Journal

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Daily estimation of the severity of multiple organ dysfunction syndrome in critically ill children

Leteurtre

Duhamel²,

Grandbastien³

et al. 2010

Canadian Medical Association Journal

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“…Wichtig ist dabei, dass der Zustand des Patienten nicht durch intensivmedizinische Maßnahmen verschleiert wird [10,21,13,14,23,25,29]. Zugrunde liegt die Idee, dass sich das Mortalitätsri-siko, das nur vor Therapiebeginn unverfälscht auf die erhobenen Messwerte Auswirkungen zeigt, aus der Grundproblematik eines Patienten ergibt.…”

Section: Aufnahmescoresunclassified

Intensivmedizinische Scoringsysteme zur täglichen Anwendung

et al. 2008

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Scoring systems are a fixed element of modern diagnostics and are integrated in the diagnosis-related groups (DRG) billing system as well as quality assurance projects. The ongoing developments require classification according to the terms of use in order to maintain an overview of the numerous systems available. In the area of intensive care medicine scoring systems can be divided into admission scores and progress scores, whereby the scores for daily assessment can be further subdivided into five categories, depending on the target criteria: objective description of the grade of organ dysfunction, progression in intensive care therapy, evaluation of the degree of nursing care, determination of outcome/mortality risk, and grouping of patient collectives for clinical trials. In future developments it will be necessary to generate new strategies to adequately describe the progress of a patient. Not only will mortality be challenged as a target criterion but also the handling of missing data and the simplification of reality by categorization practised so far that can be found in all established scoring systems as far as calculation of predictive values regarding a defined result.

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“…The elements of the SOFA score are detailed in Table 1. (15,16 Intracranial pathology may lead to nonneurologic organ dysfunction (13,14,17). Mass effect may lead to brainstem herniation and a complex physiologic response (18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

“…In 2006, more than 28 000 patients received organ transplants from more than 14 000 donors in the United States (9) (11,12). (13,14). The SOFA score is derived from six physiological variables and is calculated for each 24 h period (15,16).…”

Section: Introductionmentioning

confidence: 99%

Progression of Organ Failure in Patients Approaching Brain Stem Death

Lytle¹,

Afessa

Keegan

2009

American Journal of Transplantation

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We performed a retrospective cohort study to document the progression of organ dysfunction in 182 critically ill adult patients who subsequently met criteria for brain stem death (BSD). Patients were admitted to intensive care units (ICUs) of Mayo Medical Center, Rochester, MN, between January 1996 and December 2006. Daily sequential organ failure assessment (SOFA) scores were used to assess the degree of organ dysfunction. Serial SOFA scores were analyzed using analysis of variance (ANOVA). Mean (standard deviation, SD) SOFA score on the first ICU day was 8.9 (3.2). SOFA scores did not significantly change over the course of ICU stay. 67.6% of patients donated one or more organs after BSD was declared. The median time from ICU admission to declaration of BSD was 18.8 h (interquartile range 10.3-45.0), and in those who donated organs, the time from declaration of BSD to organ retrieval was 11.8 h (9.5-17.6). The fact that mean SOFA scores did not change significantly over time, even after BSD occurred, has implications for the timing of retrieval of organs for transplantation.

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Study of clinical course of organ dysfunction in intensive care

Abstract: Multiple organ dysfunction, does not follow a course of progressive and sequential failure. Evidence of differential daily change should further inform the use of organ failure scores as surrogate outcomes in clinical trials.

Cited by 35 publications

References 33 publications

Daily estimation of the severity of multiple organ dysfunction syndrome in critically ill children

Daily estimation of the severity of multiple organ dysfunction syndrome in critically ill children

Intensivmedizinische Scoringsysteme zur täglichen Anwendung

Progression of Organ Failure in Patients Approaching Brain Stem Death

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