Validation of APACHE II and SAPS II scales at the intensive care unit along with assessment of SOFA scale at the admission as an isolated risk of death predictor

Kądziołka, Izabela; Świstek, Rafał; Borowska, Karolina; Tyszecki, Paweł; Serednicki, Wojciech

doi:10.5114/ait.2019.86275

Cited by 50 publications

(42 citation statements)

References 16 publications

(34 reference statements)

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“…In addition, we also found that TGF-b1 gene rs1800469 locus T > C and rs1800470 C > T were associated with lower APACHE II score and SOFA score, whereas rs1800468 G > A as well as rs1800471 C > G were related to higher APACHE II score and SOFA score. We know that the APACHE II score and SOFA score are commonly used condition assessment tools for clinically critical patients (Choi et al, 2018;Kadziolka et al, 2019). This suggests that these genetic factors play a very important role in the occurrence and severity of sepsis, and analysis of the correlation between these SNP loci and plasma TGF-b1 levels may be very useful in revealing the reasons for this correlation.…”

Section: Discussionmentioning

confidence: 99%

Association of Transforming Growth Factor β1 Gene Polymorphisms and Inflammatory Factor Levels with Susceptibility to Sepsis

Zheng¹,

Fu²,

Zhao

2021

Genetic Testing and Molecular Biomarkers

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To study the association of transforming growth factor b1 (TGF-b1) gene single nucleotide polymorphisms (SNPs) and plasma TGF-b1 levels with susceptibility to sepsis. Methods: The genotypes of the TGF-b1 gene rs1800469, rs1800468, rs1800470, and rs1800471 loci in 285 sepsis patients (119 patients with severe sepsis and 166 patients with mild sepsis) and 285 healthy individuals (control group) were analyzed through Sanger sequencing. Enzyme-linked immunosorbent assay was used to detect the levels of plasma inflammatory factors. Results: The TGF-b1 gene SNP rs1800469 C allele was 0.56 times lower than the T allele in terms of risk of susceptibility to sepsis (95% confidence interval [CI]: 0.43-0.72, p < 0.01). Carriers of the A allele at the rs1800468 locus of the TGF-b1 were 2.82 times more susceptible to sepsis than those with the G allele (95% CI: 1.62-4.91, p < 0.01). The T allele at the rs1800470 locus of TGF-b1 produced a lower risk of sepsis than those with the C allele (odds ratio [OR] = 0.74, 95% CI: 0.57-0.94, p = 0.02). The risk of susceptibility to sepsis in the TGF-b1 rs1800471 locus G allele was 3.54 times higher than that of C allele (95% CI: 2.14-5.86, p < 0.01). The TGF-b1 gene rs1800469 T > C and rs1800470 C > T were associated with mild sepsis, whereas rs1800468 G > A and rs1800471 C > G were associated with severe sepsis ( p < 0.01). The TGF-b1 gene rs1800469 T > C and rs1800470 C > T were associated with lower plasma TGF-b1 levels, whereas rs1800468 G > A and rs1800471 C > G were associated with higher TGF-b1 levels ( p < 0.05). Conclusion:The alleles T > C of rs1800469 and C > T of rs1800470 of the TGF-b1 gene were associated with lower plasma TGF-b1 levels and a reduced risk of sepsis susceptibility, whereas the alleles rs1800468 G > A and rs1800471 C > G were associated with higher TGF-b1 levels and risk of susceptibility to sepsis.

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Section: Discussionmentioning

confidence: 99%

Association of Transforming Growth Factor β1 Gene Polymorphisms and Inflammatory Factor Levels with Susceptibility to Sepsis

Zheng¹,

Fu²,

Zhao

2021

Genetic Testing and Molecular Biomarkers

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“…Both CRS and rHLH can manifest as ARDS and have a similarly hyperactive immune response. Although APACHE II scores are useful in predicting mortality in patients in the intensive care unit [ 2 ], we sought a risk assessment for less critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

“…Although a growing number of case reports have been published describing coronavirus disease 2019 (COVID-19) infections in solid organ transplant recipients, few have explored formulas to predict the hospital course of this high-risk patient group. Because outcomes have ranged from mild infection [ 1 ] to death due to acute respiratory distress syndrome (ARDS) and cytokine release storm (CRS), in the severe COVID-19 cases [ 2 ] we explored the utility of a risk stratification score that could help predict outcomes in these patients. We decided to implement the H-Score, the first validated score developed for the diagnosis of reactive hemophagocytic lymphohistiocytosis (rHLH) [ 3 ].…”

mentioning

confidence: 99%

A Kidney Transplant Recipient With Coronavirus Disease 2019: Utility of a Prognostication Score

Adrogué

Mithani

Ibrahim

et al. 2020

Transplantation Proceedings

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Background Cytokine release storm (CRS) is a potentially fatal, hyperinflammatory condition common to both coronavirus disease 2019 (COVID-19) and reactive hemophagocytic lymphohistiocytosis (rHLH). We present our experience with the use of a diagnostic score, developed for rHLH, in a kidney transplant recipient hospitalized with COVID-19. Methods We applied the H-Score to risk-stratify our patient to help predict his hospital course. This study was exempt from requiring specific Institutional Review Board approval, but met all the criteria required by our institution for this type of study and report including consent from the patient. Results The calculated H-Score for our patient fell below the diagnostic cut-off value for rHLH. Because rHLH is characterized by CRS, we expected him to have a milder hospital course with COVID-19. Correlating with his below cut-off H-score, the patient had a more benign than expected hospital course. Conclusions Because this is only a single case, we plan to retrospectively review a series of patients to validate our initial experience—that a low H-Score may correlate with a milder hospital course in kidney transplant patients with COVID-19.

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“…20,21 APACHE II and SOFA scores have recently been externally validated in a single-center Polish study; recalibration was not performed. 22 Preliminary data from the Silesian registry of intensive care units showed a standardized mortality ratio for APACHE II of 0.93. No formal discrimination or calibration test was presented.…”

Section: Methodsmentioning

confidence: 99%

External validation of the sepsis severity score

Wełna

Adamik

Goździk

et al. 2020

Int J Immunopathol Pharmacol

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Introduction: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Mortality rates are high, exceeding 50% in patients with septic shock. The sepsis severity score (SSS) was developed to determine the severity of sepsis and as a prognostic model. The aim of this study was to externally validate the SSS model. Methods: Calibration and discrimination of the SSS were retrospectively evaluated using data from a single-center sepsis registry. Results: Data from 156 septic patients were recorded; 56% of them had septic shock, 94% of patients required mechanical ventilation. The observed hospital mortality was 60.3%. The mean SSS value was 94.4 (95% CI 90.5–98.3). The SSS presented excellent discrimination with an area under the receiver operating characteristic curve (AUC) of 0.806 (95% CI 0.734–0.866). The pairwise comparison of APACHE II (AUC = 0.789; 95% CI 0.715–0.851) with SSS and 1st day SOFA (AUC = 0.75; 95% CI 0.673–0.817) with SSS revealed no significant differences in discrimination between the models. The calibration of the SSS was good with the Hosmer-Lemeshow goodness-of-fit H test 9.59, P > 0.05. Analyses of calibration curve show absence of accurate predictions in lower deciles of lower risk (2nd and 4th). Conclusion: The SSS demonstrated excellent discrimination. The calibration evaluation gave conflicting results; the H-L test result indicated a good calibration, while the visual analysis of the calibration curve suggested the opposite. The SSS requires further evaluation before it can be safely recommended as an outcome prediction model.

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Validation of APACHE II and SAPS II scales at the intensive care unit along with assessment of SOFA scale at the admission as an isolated risk of death predictor

Cited by 50 publications

References 16 publications

Association of Transforming Growth Factor β1 Gene Polymorphisms and Inflammatory Factor Levels with Susceptibility to Sepsis

Association of Transforming Growth Factor β1 Gene Polymorphisms and Inflammatory Factor Levels with Susceptibility to Sepsis

A Kidney Transplant Recipient With Coronavirus Disease 2019: Utility of a Prognostication Score

External validation of the sepsis severity score

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