ABSTRACT
Objective: The objective was to find a cut off value of at admission SOFA score that best predicts outcome in critically ill patients admitted to ICU of public sector health care facility
Study Design: Cross-sectional, descriptive study
Place and Duration of Study: Medical ICU, Holy Family Hospital, Rawalpindi from February to April 2013
Material and Methods: One hundred and one patients were included. At admission SOFA score of each patient was noted. Data regarding age, gender, at admission SOFA score and outcome in terms of expired or improved [discharged/shifted from ICU] was sought. Receiver Operator Characteristics Curve [ROC] was drawn for SOFA score and poor outcome. Based on the coordinates of SOFA score and outcome ROC curve, best cut off value of SOFA scores with corresponding highest sensitivity and specificity was calculated. Outcome of patients above and below the cut off value was correlated employing Chi-square test
Results: Of the 101 patients, 39 [38.6%] improved and 62 [61.3%] expired. Mean initial SOFA score of patients who improved was 5.87 +/- 4.17 and who expired was 10.98 +/- 4.65. Coordinates of the curve showed that SOFA score cut off value 7.5 had best corresponding sensitivity [0.774] and specificity [0.744]
Based on this finding, patients were categorized to Group I [SOFA score <7], and Group II [SOFA score >8]. 32.6% of the Group I and 82.8% of the Group II patients expired [p-value 0.0000001]
Conclusion: Higher initial SOFA scores in critically ill patients is associated with higher mortality. Initial SOFA scores [<7 and >8] are best predictor of outcome in these patients
ABSTRACT
Evaluation of upper gastrointestinal [GI] endoscopy in terms of indications, diagnostic efficacy, and diseases diagnosed. Design: Retrospective, observational case series. Place and Duration of Study: DHQ Teaching Hospital, Rawalpindi, from March 1990 to December 2001. Subjects and Patients who underwent upper GI endoscopy in 12 years were included. Upper GI endoscopies were performed according to standard protocol. Endoscopic diagnoses were based on widely accepted criteria. Of the 8481 patients, 4935 [58.2%] were female and 3546 [41.8%] male. Mean patient age was 40.5 years. Dyspepsia [42.6%], upper GI bleed [32.8%], and evaluation of chronic liver disease [10.2%] were common indications of the procedure. An endoscopic diagnosis was possible in 82.6% patients. Varices, gastritis, duodenitis, and combined lesions were common endoscopic diagnosis. Gastritis and duodenitis were most frequent causes of upper GI bleed. We noted more gastric ulcers compared to duodenal ulcers. Females had significantly more normal endoscopies, p-value= 0.02. Upper GI endoscopy is an effective procedure. Dyspepsia evaluation is commonest indication for upper GI endoscopy in our patients. Etiology of upper GI bleed, and incidence of duodenal ulcer compared to gastric ulcer in our patients are different than described in literature. Females have significantly more normal endoscopies