Development of a risk prediction score for acute kidney injury in critically-ill septic Filipino patients admitted in perpetual succour hospital

Introduction@#Acute kidney injury (AKI) is a lethal complication of critical illness characterized by the rapid loss of the kidney's excretory function encountered in 50% of intensive care unit (ICU) admissions. Its impact on the outcome of critically ill patients makes AKI a significant cause of morbidity and mortality.@*Objectives@#To develop and validate an acute kidney injury risk prediction score based on routinely available variables and common laboratories of admitted critically-ill septic Filipino patients.@*Methods@#This is a prospective cohort study conducted in a tertiary hospital in Cebu from February to September 2020. The data of 2545 patients were identified by chart review but only 607 patients with a quick Sepsis Organ Failure Assessment Score (qSOFA) score of >2 were included in the pre-screening. After stratified sampling, a total of 198 septic ICU patients were enrolled. Demographic profile, laboratory results and outcome data were collated. Variables were screened then stepwise forward elimination was done to identify the significant predictors. An AKI risk score model was developed with binomial regression analysis by identifying independent prognostic factors. The diagnostic ability of the model was determined by the Area under the Receiver Operating Characteristics (AuROC).@*Results@#AKI developed in 155 (78%) patients. The significant predictors for Acute Kidney Injury were age, hypertension, atherosclerotic cardiovascular disease, weight, white blood count, creatinine, and BUN. An AKI prediction model with a cut off score of 161.9 was made with a fair diagnostic ability for predicting AKI at 0.79 based on AuROC.@*Conclusion@#The developed risk prediction tool using routinely available variables is found to be fairly accurate to predict the development of AKI among critically ill septic patients.

Socio-clinical profile, management outcomes, and predictors of mortality of COVID-19 confirmed patients admitted to Perpetual Succour Hospital from March to September 2020: A retrospective study

Introduction@#The sociodemographic factors have a substantial impact on COVID 19 and understanding the characteristics and clinical presentation of COVID-19 is essential for diagnosis, management, prevention, and targeting clinical care and allocating resources.@*Objectives@#To determine the socio-clinical profile, hospital outcomes and predictors of mortality of patients with COVID19 in Perpetual Succour Hospital from March to September 2020.@*Study Design@#Retrospective observational study@*Materials and Methods@#The population consisted of 368 COVID 19 admitted patients in a tertiary hospital in Cebu City from March to September 2020. Data collection was done by reviewing the charts of the patients and analyzing for descriptive statistics.@*Results@#The COVID 19 patients were predominantly elderly males, smokers, with hypertension and diabetes. Smoking had a significant association with the mortalities. Cough, fever and dyspnea were the common manifestations. Intubated patients had a high mortality. Age, APACHE II and SOFA score, CRP level showed significant association with mortality. Acute kidney injury was the prevalent complication and respiratory failure was the primary cause of death. Majority of the admitted patients were classified as moderate and were discharged alive.@*Conclusion@#COVID 19 has a high recovery rate but poses a risk for the elderly, smokers and those with comorbidities. The manifestations mimic those of a respiratory infection and clinical parameters would usually be typical. Furthermore, acute kidney injury is common for infected patients, with respiratory failure and the need for intubation leading to increased morbidity and mortality.

Convalescent Plasma Therapy in Filipino patients with confirmed COVID-19 infection in a tertiary hospital in Cebu City: A retrospective cohort single center study

Introduction@#Convalescent plasma therapy (CPT) is a type of experimental passive immunotherapy with a sizable background in viral outbreaks. Although there has been documented favorable outcomes in using CPT in the treatment of viral illnesses, its use in COVID-19 is still experimental.@*Objectives@#To determine if adding convalescent plasma to standard of care is associated with better clinical outcomes than giving standard of care alone to severe and critical COVID-19 patients admitted in a tertiary hospital in Cebu City.@*Methods@#This is a retrospective cohort study conducted in a tertiary hospital in Cebu between March to September 2020. The data of a total of 22 COVID-19 patients who received convalescent plasma therapy plus standard treatment regimen based on the institution's interim guideline were identified by chart review. The demographic information, laboratory results, management and outcome data from this group were collated, matched with and compared to 43 critically ill COVID-19 patients who received COVID-19 standard treatment regimen only.@*Results@#Both the CPT and non-CPT groups are comparable in terms of the socio-clinical variables, inflammatory marker levels, laboratory test results and therapeutic interventions. However, there is no relationship between the level of inflammatory markers and the illness day to which CPT was given. Additionally, the outcomes also differ significantly in terms of duration of admission, severity of illness, critical care support and mortalities. The control group has shorter hospital admissions, more patients with critical illness and more mortalities. The intervention arm, however, has more recoveries but longer duration of critical care.@*Conclusion@#Convalescent Plasma Therapy added to standard treatment is not associated with improved clinical outcomes among Filipino patients with severe or life-threatening COVID-19 infection admitted in a tertiary hospital in Cebu City.