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
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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