https://scholars.lib.ntu.edu.tw/handle/123456789/515188
標題: | SAPS 3 at dialysis commencement is predictive of hospital mortality in patients supported by extracorporeal membrane oxygenation and acute dialysis | 作者: | Tsai C.-W. YU-FENG LIN VIN-CENT WU TZONG-SHINN CHU YUNG-MING CHEN Hu F.-C. KWAN-DUN WU Ko W.-J. |
公開日期: | 2008 | 卷: | 34 | 期: | 6 | 起(迄)頁: | 1158-1164 | 來源出版物: | European Journal of Cardio-thoracic Surgery | 摘要: | Objective: This study examined the association between hospital mortality and five illness-severity scoring systems evaluated at different time points in the intensive care unit (ICU) as well as clinical variables as predictors in critically ill patients supported by extracorporeal membrane oxygenation (ECMO) and acute dialysis. Methods: This multicenter prospective observational study included 104 patients who received ECMO support and acute dialysis from January 2002 to December 2006. Patients' demographic, clinical and laboratory variables were analyzed as predictors of survival. The SAPS 2, APACHE II, SOFA, MODS, and SAPS 3 scores upon ICU admission and at acute dialysis commencement were evaluated to predict the patient's hospital mortality. Results: Hospital mortality for the study group was 76% (79/104). Among the five scoring systems, only SAPS 3 score showed a significant difference between survivors and non-survivors either upon ICU admission (p = 0.038) or at dialysis commencement (p = 0.001). SAPS 3 score at dialysis commencement showed the best discrimination ability by using the area under the receiver operating characteristic curve (SOFA, 0.55; SAPS 2, 0.56; MODS, 0.58; APACHE II, 0.59; and SAPS 3, 0.73). Multiple logistic regression analysis indicated that SAPS 3 score at dialysis commencement (OR: 1.070, 95% CI: 1.016-1.216) and IABP usage before ECMO (OR: 4.181, 95% CI: 1.448-12.075) were two independent risk factors for hospital mortality. Conclusions: Among five common ICU scoring systems evaluated at different time points, SAPS 3 at dialysis commencement is the best risk adjustment systems to predict hospital mortality in critically ill patients supported by ECMO and acute dialysis. Furthermore, the SAPS 3 score at dialysis commencement and IABP usage before ECMO are two major independent predictors for hospital mortality in patients supported by ECMO and acute dialysis. ? 2008 European Association for Cardio-Thoracic Surgery. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-55949108369&doi=10.1016%2fj.ejcts.2008.07.025&partnerID=40&md5=d69431318b4fcf476231848dce1a5c2b https://scholars.lib.ntu.edu.tw/handle/123456789/515188 |
ISSN: | 1010-7940 | DOI: | 10.1016/j.ejcts.2008.07.025 | SDG/關鍵字: | acute kidney failure; adult; APACHE; article; critically ill patient; demography; disease severity; extracorporeal oxygenation; female; hemodialysis patient; human; intensive care unit; major clinical study; male; mortality; multivariate logistic regression analysis; observational study; patient assessment; prediction; priority journal; receiver operating characteristic; risk assessment; risk factor; scoring system; simplified acute physiology score; survival rate; survival time; Adult; Age Factors; Aged; Aged, 80 and over; Area Under Curve; Bilirubin; Creatinine; Critical Illness; Extracorporeal Membrane Oxygenation; Female; Hospital Mortality; Humans; Intensive Care Units; Kidney Failure, Acute; Logistic Models; Male; Middle Aged; Prognosis; Prospective Studies; Renal Dialysis; Risk; Severity of Illness Index; Young Adult |
顯示於: | 醫學系 |
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