scholarly journals Influence of hydroxyethyl starch and gelatin versus crystalloids on renal function, fluid balance, and ICU length of stay in patients with severe sepsis

Critical Care ◽  
2010 ◽  
Vol 14 (Suppl 2) ◽  
pp. P39
Author(s):  
O Bayer ◽  
M Kohl ◽  
B Kabisch ◽  
N Riedemann ◽  
U Settmacher ◽  
...  
Keyword(s):  
Renal Function ◽  
Severe Sepsis ◽  
Length Of Stay ◽  
Hydroxyethyl Starch ◽  
Fluid Balance ◽  
Icu Length Of Stay

scholarly journals Predicting ICU length of stay using APACHE-IV in persons with severe sepsis – a pilot study

2015 ◽  
Vol 2 (1) ◽  
pp. 1 ◽  
Author(s):  
Amit Chattopadhyay ◽  
Sharmila Chatterjee
Keyword(s):  
Severe Sepsis ◽  
Length Of Stay ◽  
High Frequency ◽  
Strongly Correlated ◽  
Icu Length Of Stay ◽  
Poor Predictor ◽  
Final Sample ◽  
Iv Model ◽  
Apache Iv ◽  
Ethical Clearance

Introduction: Accurate length of stay (LOS) prediction of severe sepsis patients in intensive care unit (ICU) is critical for resource management. Acute Physiology and Chronic Health Evaluation-IV (APACHE-IV) model is commonly used forpredicting LOS. This study assesses the ICU-LOS predictability of APACHE-IV system for severe sepsis patients.Methods: Following ethical clearance, we used ICU data (06/2006 – 08/2008: from a hospital in India) to compare APACHE-IV score and predicted LOS of severe sepsis patients with actual observed ICU-LOS. We employed t-test, correlations, ANOVA andlinear regression of suitably transformed variables as needed.Results: Out of 3,949 ICU admissions, 198 were severe sepsis admissions where 134 patients (80%) had usable data. Of these 75 had verifiable APACHE-IV scores (final sample) with 55% men; median age: 67 years (IQR: 21) 53% did not have dialysis; 87% were on mechanical ventilation (MV). Mean ICU-LOS (10.1 days + 6.4) was significantly greater than predicted ICU-LOS (5.6days + 1.8 ; p<.001). ICU-LOS was very strongly correlated with days on MV (r=0.9). Mean ICU-LOS was significantly greaterfor those receiving blood transfusion (p<.001); on MV (p<.001); having surgery (p<.001) and having high frequency of dialysis (p<.001) – differences not predicted by APACHE-IV. Overall, the predicted ICU-LOS underestimation was by 4.5 days.Conclusions: The results provide a preliminary indication that APACHE-IV model may be a poor predictor of ICU-LOS insevere sepsis cases.

705 Intensive Care Unit (ICU) Length of Stay (LOS) is Associated with Postoperative Fluid Balance in Complex Spine Surgery

1999 ◽  
Vol 11 (4) ◽  
pp. 324
Author(s):  
Orit Nahtomi-Shick ◽  
John P Kostuik ◽  
Bradford D Winters ◽  
Ann N Sieber ◽  
Frederick E Sieber
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Spine Surgery ◽  
Fluid Balance ◽  
Icu Length Of Stay

scholarly journals O33: PROSPECTIVE RISK ASSESSMENT ALONE DOES NOT IMPROVE 30-DAY MORTALITY IN EMERGENCY LAPAROTOMY PATIENTS

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
S Vavilov ◽  
P Pockney
Keyword(s):  
Risk Assessment ◽  
Length Of Stay ◽  
New England ◽  
Favourable Effect ◽  
Mortality Data ◽  
Emergency Laparotomy ◽  
Icu Length Of Stay ◽  
Possum Score ◽  
Prospective Risk ◽  
American Society

Abstract Introduction Emergency laparotomy still carries a high mortality risk. According to the latest National Emergency Laparotomy Audit (NELA) report, half of the patients without pre-operative risk scoring had a higher observed than predicted mortality. Data from Perth, Australia also suggests that pre-operative scoring improves mortality. The aim of this study was to determine if a prospective risk assessment has an independent favourable effect on outcomes. Method A retrospective review of all emergency abdominal surgeries meeting NELA inclusion criteria undertaken at four different-sized Australian surgical centres was performed between April 2015 and December 2018. A predicted and observed mortality was assessed in prospectively and retrospectively risk-stratified patients. Result There were 852 patients charts reviewed during the study period. Patient demographics included 404 males (47.4%), mean age: 69 years, median American Society of Anaesthesiologists score: 3, mean length of stay: 14.0 days and mean ICU length of stay: 1.8 days. There were 72 patients who died within 30 days (8.5%). Median preoperative P-POSSUM score was 6.9%, median preoperative NELA score – 5.2%. A total of 27/133 (20.3%) patients who were scored prospectively died within 30 days; 45/719 (6.3%) retrospectively scored patients died within 30 days. Neither of these rates was very different from the predicted. Conclusion 30-day mortality in emergency laparotomy patients in Hunter New England region, Australia, compares favourably with the latest mortality figures reported by NELA. However, contrary to other publications, prospective scoring alone did not have any beneficial effect on 30-day mortality in our cohort Take-home message Patients undergoing emergency abdominal surgery require preoperative risk assessment to improve outcomes. However, just the fact of assigning a risk score preoperatively alone does not help to improve mortality.

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