Prognostic indicators related to risk of death in shock patients: a new simplified score.
Journal Title: Singapore Medical Journal - Year 2011, Vol 52, Issue 2
Abstract
Introduction: We analysed the parameters associated with mortality outcome in shock patients. Methods: The databases of intensive care unit patients were retrieved, and shock patients were selected for further analysis. Logistic regression was used to identify the predictors of mortality outcome. The area under curve (AUC) of receiver operating characteristic (ROC) curve was calculated for the power of prediction model. Results: A total of 467 patients were recruited, of which 183 patients were diagnosed with shock. The variables predicting mortality outcomes were heart rate above 130 beats/minute (p-value is 0.015, odds ratio [OR] 4.38, 95 percent confidence interval [CI] 1.338-14.321), pH less than or equal to 7.24 (p-value is 0.001, OR 6.11, 95 percent CI 2.17-17.18), creatinine more than 1.5 mg/dl (p-value is 0.048, OR 3.05, 95 percent CI 1.01-9.19), and Glasgow Coma Score less than 7 (p-value is 0.038, OR 3.476, 95 percent CI 1.07-11.27). The sensitivity, specificity and AUC of ROC of this model was 82.5, 60.5 and 0.826 percent, respectively. The positive and negative predictive values and AUC of ROC at a score below 2 was 82.8, 67.3 and 0.81 percent, respectively. The results revealed a significant improvement in survival in shock patients with a score below 2 (p-value less than 0.001). We prospectively validated the score in 107 shock patients and found very high AUC of ROC. Conclusion: Acidosis, tachycardia, renal impairment and impaired consciousness within the first 24 hours are the main predictors of shock state, and should be used for assessment of survival outcome in shock patients.
Authors and Affiliations
P Theerawit, S Kiastboonsri, A Ingsathit, K Tanwattanathavorn
Keywords
Related Articles
- EP ID EP134638
- DOI -
- Views 87
- Downloads 0
Vascular malformation of the jejunum associated with nodal non-Hodgkin's malignant lymphoma.
We report a case of multiple minute angioectasia of the jejunum presenting with fatal gastrointestinal bleeding. Repeated endoscopies, mesenteric angiography and scintigraphy failed to locate the bleeding site. Multiple...
Ministry of health clinical practice guidelines: screening of cardiovascular disease and risk factors.
The Ministry of Health (MOH) publishes clinical practice guidelines on Screening of Cardiovascular Disease and Risk Factors to provide doctors and patients in Singapore with evidence-based guidance on the screening of ca...
Early postoperative outcome after curative colorectal cancer surgery.
Colorectal cancer is uncommon in the Indian subcontinent, so there is a paucity of outcome data from this region. The aim of our study was to identify risk factors for early postoperative morbidity and mortality followin...
Can minimally invasive percutaneous plate osteosynthesis be a viable answer in such situations?
New clinical sign of cervical myelopathy: Wazir hand myelopathy sign.
Cervical spondylotic myelopathy (CSM) represents a spectrum of pathologies with progressive compression of the spinal cord. The clinical signs and symptoms play a key role in diagnosis. The characteristic hand myelopathy...