Patterns and early evolution of organ failure in the intensive care unit and their relation to outcome

INTRODUCTION: Recognition of patterns of organ failure may be useful in characterizing the clinical course of critically ill patients. We investigated the patterns of early changes in organ dysfunction/failure in intensive care unit (ICU) patients and their relation to outcome. METHODS: Using the da...

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Autores principales: Sakr, Yasser, Lobo, Suzana M, Moreno, Rui P, Gerlach, Herwig, Ranieri, V Marco, Michalopoulos, Argyris, Vincent, Jean-Louis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672601/
https://www.ncbi.nlm.nih.gov/pubmed/23158219
http://dx.doi.org/10.1186/cc11868
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author Sakr, Yasser
Lobo, Suzana M
Moreno, Rui P
Gerlach, Herwig
Ranieri, V Marco
Michalopoulos, Argyris
Vincent, Jean-Louis
author_facet Sakr, Yasser
Lobo, Suzana M
Moreno, Rui P
Gerlach, Herwig
Ranieri, V Marco
Michalopoulos, Argyris
Vincent, Jean-Louis
author_sort Sakr, Yasser
collection PubMed
description INTRODUCTION: Recognition of patterns of organ failure may be useful in characterizing the clinical course of critically ill patients. We investigated the patterns of early changes in organ dysfunction/failure in intensive care unit (ICU) patients and their relation to outcome. METHODS: Using the database from a large prospective European study, we studied 2,933 patients who had stayed more than 48 hours in the ICU and described patterns of organ failure and their relation to outcome. Patients were divided into three groups: patients without sepsis, patients in whom sepsis was diagnosed within the first 48 hours after ICU admission, and patients in whom sepsis developed more than 48 hours after admission. Organ dysfunction was assessed by using the sequential organ failure assessment (SOFA) score. RESULTS: A total of 2,110 patients (72% of the study population) had organ failure at some point during their ICU stay. Patients who exhibited an improvement in organ function in the first 24 hours after admission to the ICU had lower ICU and hospital mortality rates compared with those who had unchanged or increased SOFA scores (12.4 and 18.4% versus 19.6 and 24.5%, P < 0.05, pairwise). As expected, organ failure was more common in sepsis than in nonsepsis patients. In patients with single-organ failure, in-hospital mortality was greater in sepsis than in nonsepsis patients. However, in patients with multiorgan failure, mortality rates were similar regardless of the presence of sepsis. Irrespective of the presence of sepsis, delta SOFA scores over the first 4 days in the ICU were higher in nonsurvivors than in survivors and decreased significantly over time in survivors. CONCLUSIONS: Early changes in organ function are strongly related to outcome. In patients with single-organ failure, in-hospital mortality was higher in sepsis than in nonsepsis patients. However, in multiorgan failure, mortality rates were not influenced by the presence of sepsis.
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spelling pubmed-36726012013-06-10 Patterns and early evolution of organ failure in the intensive care unit and their relation to outcome Sakr, Yasser Lobo, Suzana M Moreno, Rui P Gerlach, Herwig Ranieri, V Marco Michalopoulos, Argyris Vincent, Jean-Louis Crit Care Research INTRODUCTION: Recognition of patterns of organ failure may be useful in characterizing the clinical course of critically ill patients. We investigated the patterns of early changes in organ dysfunction/failure in intensive care unit (ICU) patients and their relation to outcome. METHODS: Using the database from a large prospective European study, we studied 2,933 patients who had stayed more than 48 hours in the ICU and described patterns of organ failure and their relation to outcome. Patients were divided into three groups: patients without sepsis, patients in whom sepsis was diagnosed within the first 48 hours after ICU admission, and patients in whom sepsis developed more than 48 hours after admission. Organ dysfunction was assessed by using the sequential organ failure assessment (SOFA) score. RESULTS: A total of 2,110 patients (72% of the study population) had organ failure at some point during their ICU stay. Patients who exhibited an improvement in organ function in the first 24 hours after admission to the ICU had lower ICU and hospital mortality rates compared with those who had unchanged or increased SOFA scores (12.4 and 18.4% versus 19.6 and 24.5%, P < 0.05, pairwise). As expected, organ failure was more common in sepsis than in nonsepsis patients. In patients with single-organ failure, in-hospital mortality was greater in sepsis than in nonsepsis patients. However, in patients with multiorgan failure, mortality rates were similar regardless of the presence of sepsis. Irrespective of the presence of sepsis, delta SOFA scores over the first 4 days in the ICU were higher in nonsurvivors than in survivors and decreased significantly over time in survivors. CONCLUSIONS: Early changes in organ function are strongly related to outcome. In patients with single-organ failure, in-hospital mortality was higher in sepsis than in nonsepsis patients. However, in multiorgan failure, mortality rates were not influenced by the presence of sepsis. BioMed Central 2012 2012-11-16 /pmc/articles/PMC3672601/ /pubmed/23158219 http://dx.doi.org/10.1186/cc11868 Text en Copyright ©2012 Sakr et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Sakr, Yasser
Lobo, Suzana M
Moreno, Rui P
Gerlach, Herwig
Ranieri, V Marco
Michalopoulos, Argyris
Vincent, Jean-Louis
Patterns and early evolution of organ failure in the intensive care unit and their relation to outcome
title Patterns and early evolution of organ failure in the intensive care unit and their relation to outcome
title_full Patterns and early evolution of organ failure in the intensive care unit and their relation to outcome
title_fullStr Patterns and early evolution of organ failure in the intensive care unit and their relation to outcome
title_full_unstemmed Patterns and early evolution of organ failure in the intensive care unit and their relation to outcome
title_short Patterns and early evolution of organ failure in the intensive care unit and their relation to outcome
title_sort patterns and early evolution of organ failure in the intensive care unit and their relation to outcome
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672601/
https://www.ncbi.nlm.nih.gov/pubmed/23158219
http://dx.doi.org/10.1186/cc11868
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