ABSTRACT
Objective: To estimate the value of combinative index [combination of routine biomarkers] for predicting 28-day mortality in patients with sepsis
Study Design: An observational study
Place and Duration of Study: Department of Intensive Care Unit, the Second Hospital of Shandong University, Jinan, China, from August 2016 to December 2016
Methodology: Logistic regressions of biomarkers and a combination of biomarkers were performed to investigate risk factors for mortality in patients with sepsis. Several biomarkers were analysed in combination using receiver operating characteristic curves to evaluate the diagnostic performance of combinative index
Results: A total of 59 patients were enrolled; 13 were diagnosed as septic shock. The 28-day mortality rate was 22.0%.Univariate analysis revealed that nonsurvival patients were much older [p=0.022], with higher level of lactate [p=0.012], and with higher level of NT-proBNP [p=0.008] than survival patients. Multivariate logistic regression analysis identified arterial lactate [OR 8.62, 95% CI 1.07-71.43, p=0.043], NT-proBNP [OR 1.00, 95% CI 1.00-1.01, p=0.021], and CRP [OR 1.05, 95% CI 1.01-1.10, p=0.036] as independent predictors for 28-day mortality of septic patients. The combinative index [arterial lactate, NT-proBNP and CRP] displayed a better diagnostic performance than any single indicator [p=0.05, 0.02 and 0.02, respectively]
Conclusion: Combinative index [arterial lactate, NT-proBNP and CRP] could serve as a valuable predictor for the 28-day mortality rate in patients with sepsis
ABSTRACT
Objective:To investigate the bedside index for severity in acute pancreatitis(BISAP) score combined with red cell distribution width (red cell distribution width,RDW) on acute pancreatitis (AP) and early assessment of the severity of value.Methods:385 patients with acute pancreatitis were collected from October 2015 to November 2017 in our hospital,according to the severity of the disease were divided into mild group (MAP),moderately severe group (MSAP) and severe group (SAP),patients admitted to hospital within 24h,blood urea nitrogen,blood glucose,blood examination,collection of red blood cells in parallel the BISAP score distribution width,using analysis of variance statistical differences between three groups of data,and draw the RDW combined with BISAP score in predicting the progression of AP receiver operating characteristic curve analysis and its predictive value.Results:Mild group,moderately severe group,severe BISAP score and red blood cell distribution 0width increased sequentially.There was a significant difference in RDW and BISAP scores between the three groups (P＜0.05),and RDW was positively correlated with BISAP score (r=0.384,P＜0.01).The area under the curve of BISAP score,RDW combined with BISAP score for predicting AP disease was 0.879 and 0.894 respectively,and the sensitivity was 77.3％,95.5％,and the specificity was 85.3％ and 76.5％.Conclusion:With the aggravation of AP patients,both the BISAP score and the RDW increase.The combination of the two is helpful to predict the patient's condition.
ABSTRACT
Surgical complication after biliary tract injury are serious complications of Hepatobiliary surgery. The incidence of iatrogenic bile duct injuries has increased significantly since the number of cholecystectomy operations have increased, laparoscopic cholecystectomy became the "gold standard", mini-cholecystectomy established for the treatment of cholelithiasis. Intraoperative hemorrhage can be life-threatening or may lead the death. The common uses of laparoscopic cholecystectomy and mini-cholecystectomy have made the young surgeons less familiar with open cholecystectomy procedure and the approaches to manage the biliary tract injuries. Uncommonly the patient had to undergo hepatic transplantation secondary to biliary tract surgery with several vessel injuries or biliary cirrhosis. Postoperative bile leakage can be managed by effective drainage as soon as possible. These complications uncommon with the expert surgeons, but common with comparatively inexperienced surgeons. There is no substitute of experience and caution in biliary surgery for optimization technique