Tag Archives: mortality

Predictors of mortality in patients with early versus late onset of septic shock. A prospective, observational and comparative pilot study

DOI: 10.2478/amma-2024-0027

Introduction: Outcome and predictors of early- and late-onset septic shock are still controversial. The aim of the study was to compare the relevant predictors of 28-day mortality in early- and late-onset septic shock and other non-septic critical illnesses.
Material and Methods: We conducted a prospective, observational, pilot study. A group of 46 patients with early septic shock and 42 non-septic critically ill patients from the emergency department and 56 patients with late septic shock from the hospital were enrolled. On admission to the ICU, the most important potential predictors of 28-day mortality were assessed.
Results: In terms of predicting 28-day mortality, a higher mNUTRIC score was the only common predictor for all three groups. Multi-drug resistant (MDR) bacterial aetiology was a common predictor in both forms of septic shock. Older age, female gender, increased neutrophil-to-lymphocyte ratio (NLR) and increased need for vasoactive agents were common predictors in late septic shock and non-septic critically ill patients. Increased red blood cell distribution width coefficient of variation (RDW-CV) was predictor in early septic shock and non-septic critically ill patients. Central venous-arterial carbon dioxide difference (Pcv-aCO2) was predictor in patients with early septic shock. Inflammatory index and MDR carrier status were predictors in non-septic critically ill patients.
Conclusions:A higher mNUTRIC score is a predictor of 28-day mortality in early and late septic shock and in critically ill non-septic patients. MDR aetiology was predictive of 28-day all-cause mortality in both types of septic shock, and Pcv-aCO2 was predictive in patients with early septic shock.

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Establishing the Diagnostic and Prognostic Value of Serum Interleukin 6 Levels in Sepsis

DOI: 10.2478/amma-2020-0014

Objective: Establishing a serological profile of interleukin 6 (IL-6) in order to evaluate its usefulness as a biological marker for the diagnosis and early prognosis in sepsis.
Materials and Methods: The study included 246 individuals, divided into 2 groups: 131 in the septic subgroup (S) and 115 in the septic shock (SS) subgroup. Inflammatory markers, bacteriological examinations and laboratory samples were determined within 24 hours of the first signs of infection. Severity scores were also calculated within the first day of the onset of sepsis.
Results: The SS subgroup (median 121.2 pg/ml, 18.59-10235 pg/ml; SD = 1920) shows significantly higher values of IL-6, compared to the S subgroup (median 43.49 pg/ml, 13, 27-6566 pg/ml; SD = 1367) (p = 0.0026). The SS subgroup has a significantly higher death rate than S subgroup (p = 0.001). The cut-off values of the mortality prediction degree were 184.74 pg/ml. The area under the curve of the cytokine IL-6 for the differentiation of sepsis from septic shock was 0.693 (95% CI 0.582-0.790, p = 0.002). The optimal value of the cut-off that allows the differentiation of the septic subgroup from the one with organ dysfunction, was 52.72 pg / ml.
Conclusion: Serum IL-6 values are significantly higher in the septic shock group. All deceased patients had higher IL-6 serum values.

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