ABSTRACT
The purpose of the present study was to explore the usefulness of the Mexican sequential organ failure assessment (MEXSOFA) score for assessing the risk of mortality for critically ill patients in the ICU. A total of 232 consecutive patients admitted to an ICU were included in the study. The MEXSOFA was calculated using the original SOFA scoring system with two modifications: the PaO2/FiO2 ratio was replaced with the SpO2/FiO2 ratio, and the evaluation of neurologic dysfunction was excluded. The ICU mortality rate was 20.2%. Patients with an initial MEXSOFA score of 9 points or less calculated during the first 24 h after admission to the ICU had a mortality rate of 14.8%, while those with an initial MEXSOFA score of 10 points or more had a mortality rate of 40%. The MEXSOFA score at 48 h was also associated with mortality: patients with a score of 9 points or less had a mortality rate of 14.1%, while those with a score of 10 points or more had a mortality rate of 50%. In a multivariate analysis, only the MEXSOFA score at 48 h was an independent predictor for in-ICU death with an OR = 1.35 (95%CI = 1.14-1.59, P < 0.001). The SOFA and MEXSOFA scores calculated 24 h after admission to the ICU demonstrated a good level of discrimination for predicting the in-ICU mortality risk in critically ill patients. The MEXSOFA score at 48 h was an independent predictor of death; with each 1-point increase, the odds of death increased by 35%.
Subject(s)
Multiple Organ Failure/classification , Organ Dysfunction Scores , Critical Illness , Female , Humans , Intensive Care Units , Male , Middle Aged , Multiple Organ Failure/mortality , Prospective Studies , ROC Curve , Severity of Illness IndexABSTRACT
The purpose of the present study was to explore the usefulness of the Mexican sequential organ failure assessment (MEXSOFA) score for assessing the risk of mortality for critically ill patients in the ICU. A total of 232 consecutive patients admitted to an ICU were included in the study. The MEXSOFA was calculated using the original SOFA scoring system with two modifications: the PaO2/FiO2 ratio was replaced with the SpO2/FiO2 ratio, and the evaluation of neurologic dysfunction was excluded. The ICU mortality rate was 20.2%. Patients with an initial MEXSOFA score of 9 points or less calculated during the first 24 h after admission to the ICU had a mortality rate of 14.8%, while those with an initial MEXSOFA score of 10 points or more had a mortality rate of 40%. The MEXSOFA score at 48 h was also associated with mortality: patients with a score of 9 points or less had a mortality rate of 14.1%, while those with a score of 10 points or more had a mortality rate of 50%. In a multivariate analysis, only the MEXSOFA score at 48 h was an independent predictor for in-ICU death with an OR = 1.35 (95%CI = 1.14-1.59, P < 0.001). The SOFA and MEXSOFA scores calculated 24 h after admission to the ICU demonstrated a good level of discrimination for predicting the in-ICU mortality risk in critically ill patients. The MEXSOFA score at 48 h was an independent predictor of death; with each 1-point increase, the odds of death increased by 35%.
Subject(s)
Female , Humans , Male , Middle Aged , Multiple Organ Failure/classification , Organ Dysfunction Scores , Critical Illness , Intensive Care Units , Multiple Organ Failure/mortality , Prospective Studies , ROC Curve , Severity of Illness IndexABSTRACT
The objectives of this study were to identify risk factors associated with mortality in patients with systemic lupus erythematosus (SLE) admitted to the intensive care unit (ICU) and to evaluate the usefulness of Acute Physiologic and Chronic Health Evaluation (APACHE) II score to predict outcomes in these patients, through the use of a retrospective patient record review from a multidisciplinary intensive care unit in a teaching hospital. One hundred and four patients with SLE admitted to the ICU were included in the study. The mean age of patients was 32.44 years, 96.2% were female and 61.5% were admitted with infection. The mean APACHE II score was 19.7, 46.2% had acute renal dysfunction, 67.3% received inotropics/ vasopressors, 27.9% pulmonary artery catheter and 74% invasive mechanical ventilation. The mean length of stay in ICU was 18.5 days and mortality rate was 32.7%. In the univariate logistic regression analysis, factors associated with mortality were high APACHE II score, use of inotropics/vasopressors, pulmonary artery catheter and invasive mechanical ventilation. High APACHE II score and use of inotropics/vasopressors remained significant in the multi-variate analysis. The area under the receiver operating characteristic curve of the APACHE II score to predict mortality was 0.689 (95% CI 0.586-0.791 p = 0.002) and the Hosmer- Lemeshow chi( 2) was 5.094 (p = 0.747). We conclude that the mortality rate in patients with SLE admitted to the ICU is high. The most common cause of admission was infection. The factors associated with mortality were high APACHE II score and the use of inotropics/vasopressors. APACHE II score was unable to accurately predict mortality.
