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
To note obesity related complications in subjects of age range 50-59 years. A case control study was conducted at Medical Unit of District Headquarters Hospital, Rawalpindi for 6 months. Hundred obese subjects in the age range 50-59 years and their age matched non-obese 100 controls were included consecutively from general population. Obese subjects had body mass index [BMI] >30Kg/m2. Controls had BMI of 18.5-22.9Kg/m2 and normal waist hip ratio. Obesity related complications i.e., hypertension, diabetes mellitus, ischemic heart disease, stroke, hyperlipidemia, gall stones, varicose veins, psychological problems, sleep related problems, and degenerative arthritis, were sought in all subjects. Waist hip ratio was noted as measure of central distribution of body fat in obese subjects. Of the 200 subjects, 59% [n=118] were female and 41% [n=82] male. Of the obese subjects 74% and 44% of non-obese controls were female. Mean age of obese subjects and their controls was 54.4'3.22 and 54.57'3.54 years respectively. Central obesity was noted in 84% of obese subjects. Hyperlipidemia [87%], hypertension [71%], diabetes mellitus [65%], gallstones [57%], ischaemic heart disease [49%], osteoarthritis [46%], and sleep disorders [35%] were significant [p<0.05] obesity related complications. Hyperlipidemia, hypertension, diabetes mellitus, gallstones, ischaemic heart disease, osteoarthritis and sleep disorders are common obesity related complications in subjects of age range 50-59 years