Decreased serial scores of severe organ failure assessments are associated with survival in mechanically ventilated patients; the prospective Maastricht Intensive Care COVID cohort.

Autor: Bels JLM; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, the Netherlands. Electronic address: julia.bels@mumc.nl., van Kuijk SMJ; Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, Maastricht, the Netherlands. Electronic address: sander.van.kuijk@mumc.nl., Ghossein-Doha C; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; Department of Cardiology, Maastricht University Medical Centre+, Maastricht, the Netherlands; School for Oncology & Developmental Biology (GROW), Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, the Netherlands. Electronic address: chahinda.ghossein@mumc.nl., Tijssen FH; Department of Anaesthesiology and Pain Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands. Electronic address: fabian.tijssen@mumc.nl., van Gassel RJJ; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; Department of Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands; School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, the Netherlands. Electronic address: r.vangassel@maastrichtuniversity.nl., Tas J; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre+, Maastricht, the Netherlands. Electronic address: jeanette.tas@mumc.nl., Collaborators M; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands., Schnabel RM; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands. Electronic address: r.schnabel@mumc.nl., Aries MJH; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre+, Maastricht, the Netherlands. Electronic address: marcel.aries@mumc.nl., van de Poll MCG; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; Department of Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands; School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, the Netherlands. Electronic address: marcel.vande.poll@mumc.nl., Bergmans DCJJ; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands. Electronic address: d.bergmans@mumc.nl., Meex SJR; Department of Clinical Chemistry, Central Diagnostic Laboratory, Maastricht University Medical Centre+, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands. Electronic address: steven.meex@mumc.nl., van Mook WNKA; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; School of Health Professions Education, Maastricht University, Universiteitssingel 60, 6229 ER Maastricht, the Netherlands. Electronic address: w.van.mook@mumc.nl., van der Horst ICC; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands. Electronic address: iwan.vander.horst@mumc.nl., van Bussel BCT; Department of Intensive Care, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, the Netherlands. Electronic address: bas.van.bussel@mumc.nl.
Jazyk: angličtina
Zdroj: Journal of critical care [J Crit Care] 2021 Apr; Vol. 62, pp. 38-45. Date of Electronic Publication: 2020 Nov 17.
DOI: 10.1016/j.jcrc.2020.11.006
Abstrakt: Background: The majority of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are admitted to the Intensive Care Unit (ICU) for mechanical ventilation. The role of multi-organ failure during ICU admission as driver for outcome remains to be investigated yet.
Design and Setting: Prospective cohort of mechanically ventilated critically ill with SARS-CoV-2 infection.
Participants and Methods: 94 participants of the MaastrICCht cohort (21% women) had a median length of stay of 16 days (maximum of 77). After division into survivors (n = 59) and non-survivors (n = 35), we analysed 1555 serial SOFA scores using linear mixed-effects models.
Results: Survivors improved one SOFA score point more per 5 days (95% CI: 4-8) than non-survivors. Adjustment for age, sex, and chronic lung, renal and liver disease, body-mass index, diabetes mellitus, cardiovascular risk factors, and Acute Physiology and Chronic Health Evaluation II score did not change this result. This association was stronger for women than men (P-interaction = 0.043).
Conclusions: The decrease in SOFA score associated with survival suggests multi-organ failure involvement during mechanical ventilation in patients with SARS-CoV-2. Surviving women appeared to improve faster than surviving men. Serial SOFA scores may unravel an unfavourable trajectory and guide decisions in mechanically ventilated patients with SARS-CoV-2.
Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests.
(Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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