The impact of extracerebral organ failure on outcome of patients after cardiac arrest: an observational study from the ICON database
Autor: | Xavier Wittebole, Peter Pickkers, Yasser Sakr, Fabio Silvio Taccone, Tamas Szakmany, Leda Nobile, Marc Leone, Massimo Antonelli, Jean Louis Vincent, Tommaso Pellis, Stephan M. Jakob |
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Přispěvatelé: | Department of Intensive Care and Anesthesiology, Università cattolica del Sacro Cuore [Milano] (Unicatt), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Université libre de Bruxelles (ULB), Pilvinis, Vidas, Vosylius, Saulius, Kėkštas, Gintautas, Balčiūnas, Mindaugas, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), UCL - (SLuc) Service de soins intensifs, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë |
Jazyk: | angličtina |
Rok vydání: | 2016 |
Předmět: |
Male
medicine.medical_specialty Critical Care Databases Factual Multiple Organ Failure medicine.medical_treatment lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] 610 Medicine & health 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine computer.software_genre Cohort Studies 03 medical and health sciences 0302 clinical medicine [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases Intensive care Settore MED/41 - ANESTESIOLOGIA medicine Humans Hospital Mortality Prospective Studies Simplified Acute Physiology Score Prospective cohort study Aged Mechanical ventilation Coma Database organ failure cardiac arrest extracerebral business.industry Research Organ dysfunction Généralités 030208 emergency & critical care medicine Middle Aged R1 Heart Arrest Intensive Care Units SAPS II Emergency medicine Female medicine.symptom business computer Cohort study |
Zdroj: | Nobile, Leda; Taccone, Fabio S; Szakmany, Tamas; Sakr, Yasser; Jakob, Stephan; Pellis, Tommaso; Antonelli, Massimo; Leone, Marc; Wittebole, Xavier; Pickkers, Peter; Vincent, Jean-Louis (2016). The impact of extracerebral organ failure on outcome of patients after cardiac arrest: an observational study from the ICON database. Critical care, 20(1), p. 368. BioMed Central 10.1186/s13054-016-1528-6 Critical Care, 20, 1, pp. 368 Critical Care Critical Care, 2016, 20, ⟨10.1186/s13054-016-1528-6⟩ Critical care, London, BioMed Central Ltd, 2016, Vol. 20, Art. no 368 [p. 368-375] Critical Care, 20, 368 Critical Care, BioMed Central, 2016, 20, ⟨10.1186/s13054-016-1528-6⟩ Critical care, 20 (1 Critical Care, Vol. 20, no. 1, p. 368 [1-10] (2016) |
ISSN: | 1364-8535 1466-609X |
Popis: | Background: We used data from a large international database to assess the incidence and impact of extracerebral organ dysfunction on prognosis of patients admitted after cardiac arrest (CA). Methods: This was a sub-analysis of the Intensive Care Over Nations (ICON) database, which contains data from all adult patients admitted to one of 730 participating intensive care units (ICUs) in 84 countries from 8-18 May 2012, except admissions for routine postoperative surveillance. For this analysis, patients admitted after CA (defined as those with "post-anoxic coma" or "cardiac arrest" as the reason for ICU admission) were included. Data were collected daily in the ICU for a maximum of 28 days; patients were followed up for outcome data until death, hospital discharge, or a maximum of 60 days in-hospital. Favorable neurological outcome was defined as alive at hospital discharge with a last available neurological Sequential Organ Failure Assessment (SOFA) subscore of 0-2. Results: Among the 469 patients admitted after CA, 250 (53 %) had had out-of-hospital CA; 210 (45 %) patients died in the ICU and 357 (76 %) had an unfavorable neurological outcome. Non-survivors had a higher incidence of renal (43 vs. 16 %), cardiovascular (56 vs. 45 %), and respiratory (62 vs. 48 %) failure on admission and during the ICU stay than survivors (all p < 0.05). Similar results were found for patients with unfavorable vs. favorable neurological outcomes. In multivariable analysis, independent predictors of ICU mortality were renal failure on admission, high admission Simplified Acute Physiology Score (SAPS) II, high maximum serum lactate levels within the first 24 h after ICU admission, and development of sepsis. Independent predictors of unfavorable neurological outcome were mechanical ventilation on admission, high admission SAPS II score, and neurological dysfunction on admission. Conclusions: In this multicenter cohort, extracerebral organ dysfunction was common in CA patients. Renal failure on admission was the only extracerebral organ dysfunction independently associated with higher ICU mortality. SCOPUS: ar.j info:eu-repo/semantics/published |
Databáze: | OpenAIRE |
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