ABSTRACT
Background:@#Sepsis-3 definitions have been published recently; however, their diagnostic value remains controversial. This study was to assess the accuracy of Sepsis-3 definitions compared to Sepsis-1 definitions by stratifying mortality among adult critically ill patients with suspected infection.@*Methods:@#A multicenter, prospective cohort study was conducted from November 10, 2017 to October 10, 2018, in five Intensive Care Units (ICUs) at four teaching hospitals. Thirty-day mortality was compared across categories for both Sepsis-3 definitions and Sepsis-1 definitions, which were evaluated by logistic regression analysis followed by measurement of the area under the receiver operating characteristic curve (AUROC) for predicting 30-day mortality rates.@*Results:@#Of the 749 enrolled patients, 644 (85.9%) were diagnosed with sepsis according to the Sepsis-1 definitions. Among those patients, 362 were diagnosed with septic shock (362/749, 48.3%). However, according to the Sepsis-3 definitions, there were 483 patients with a diagnosis of sepsis (483/749, 64.5%), among whom 299 patients were diagnosed with septic shock (299/749, 39.9%). According to the Sepsis-3 definitions, sepsis (sepsis and septic shock) patients had higher 30-day mortality (41.8%) than sepsis patients according to the Sepsis-1 definitions (31.8%, χ2 = 5.552, P = 0.020). The AUROC of systemic inflammatory response syndrome (SIRS) and quick sequential organ failure assessment (qSOFA) scores with regard to 30-day mortality rates were 0.609 (0.566–0.652) and 0.694 (0.654–0.733), respectively. However, the AUROC of SOFA scores (0.828 [0.795–0.862]) were significantly higher than that of SIRS or qSOFA scores (P < 0.001).@*Conclusion:@#In adult critically ill patients with suspected infection, the Sepsis-3 definitions were relatively accurate in stratifying mortality and were superior to the Sepsis-1 definitions.@*Trial Registration:@#www.chictr.org.cn (ChiCTR-OOC-17013223).
ABSTRACT
BACKGROUND@#Sepsis-3 definitions have been published recently; however, their diagnostic value remains controversial. This study was to assess the accuracy of Sepsis-3 definitions compared to Sepsis-1 definitions by stratifying mortality among adult critically ill patients with suspected infection.@*METHODS@#A multicenter, prospective cohort study was conducted from November 10, 2017 to October 10, 2018, in five Intensive Care Units (ICUs) at four teaching hospitals. Thirty-day mortality was compared across categories for both Sepsis-3 definitions and Sepsis-1 definitions, which were evaluated by logistic regression analysis followed by measurement of the area under the receiver operating characteristic curve (AUROC) for predicting 30-day mortality rates.@*RESULTS@#Of the 749 enrolled patients, 644 (85.9%) were diagnosed with sepsis according to the Sepsis-1 definitions. Among those patients, 362 were diagnosed with septic shock (362/749, 48.3%). However, according to the Sepsis-3 definitions, there were 483 patients with a diagnosis of sepsis (483/749, 64.5%), among whom 299 patients were diagnosed with septic shock (299/749, 39.9%). According to the Sepsis-3 definitions, sepsis (sepsis and septic shock) patients had higher 30-day mortality (41.8%) than sepsis patients according to the Sepsis-1 definitions (31.8%, χ = 5.552, P = 0.020). The AUROC of systemic inflammatory response syndrome (SIRS) and quick sequential organ failure assessment (qSOFA) scores with regard to 30-day mortality rates were 0.609 (0.566-0.652) and 0.694 (0.654-0.733), respectively. However, the AUROC of SOFA scores (0.828 [0.795-0.862]) were significantly higher than that of SIRS or qSOFA scores (P < 0.001).@*CONCLUSION@#In adult critically ill patients with suspected infection, the Sepsis-3 definitions were relatively accurate in stratifying mortality and were superior to the Sepsis-1 definitions.@*TRIAL REGISTRATION@#www.chictr.org.cn (ChiCTR-OOC-17013223).
ABSTRACT
Objective To explore the preventive effect of low molecular weight heparin calcium in severe burn patients with venous thrombosis. Methods 64 patients of lower extremity burns complicated by systemic inflammatory response in Taizhou Enze medical center (Group) Enze hospital from March 2016 to 2017 March as the research object, were received once daily subcutaneous injection of 2850 U (0.3 mL) low molecular weight heparin calcium treatment, continuous injection of 10 d. The control group was given the routine nursing on the basis treatment, the observation group was given nursing intervention, the incidence rate of deep venous thrombosis and nursing satisfaction rate were compared between two groups. Methods FIB and blood D-dimer in the seventh day after treatment were improved (P<0.05) , PT and APTT in the seventh day after treatment were increased (P<0.05) , the level of FIB in the seventeenth day after treatment was significantly lower than the first day and the seventh day. The incidence of deep vein thrombosis in the observation group was significantly lower than the control group, nursing satisfaction rate in the observation group was higher than the control group, the difference was statistically significant (P<0.05). Conclusion Subcutaneous injection of low molecular weight heparin calcium in patients who are in high blood coagulation state after moderately severe burns SIRS can effectively prevent deep venous thrombosis, auxiliary nursing intervention is helpful to promote the rehabilitation of patients and improve nursing satisfaction.
ABSTRACT
Objective To explore the preventive effect of low molecular weight heparin calcium in severe burn patients with venous thrombosis. Methods 64 patients of lower extremity burns complicated by systemic inflammatory response in Taizhou Enze medical center (Group) Enze hospital from March 2016 to 2017 March as the research object, were received once daily subcutaneous injection of 2850 U (0.3 mL) low molecular weight heparin calcium treatment, continuous injection of 10 d. The control group was given the routine nursing on the basis treatment, the observation group was given nursing intervention, the incidence rate of deep venous thrombosis and nursing satisfaction rate were compared between two groups. Methods FIB and blood D-dimer in the seventh day after treatment were improved (P<0.05) , PT and APTT in the seventh day after treatment were increased (P<0.05) , the level of FIB in the seventeenth day after treatment was significantly lower than the first day and the seventh day. The incidence of deep vein thrombosis in the observation group was significantly lower than the control group, nursing satisfaction rate in the observation group was higher than the control group, the difference was statistically significant (P<0.05). Conclusion Subcutaneous injection of low molecular weight heparin calcium in patients who are in high blood coagulation state after moderately severe burns SIRS can effectively prevent deep venous thrombosis, auxiliary nursing intervention is helpful to promote the rehabilitation of patients and improve nursing satisfaction.