Selected article for: "increase mortality and specificity sensitivity"
Author: Loyrion, Emmanuelle; Agier, Lydiane; Trouve-Buisson, Thibaut; Gavazzi, Gaetan; Schwebel, Carole; Bosson, Jean-Luc; Payen, Jean-François
Title: Dynamic SOFA score assessments to predict outcomes after acute admission of octogenarians to the intensive care unit
  • Cord-id: ig5eg6pw
  • Document date: 2021_8_2
    • ID: ig5eg6pw
    Snippet: BACKGROUND: Identifying which octogenarians could benefit most from continuing critical care is challenging. We aimed to see if responses to therapies using the sequential organ failure assessment (SOFA) score on day 4 after unplanned admission to the intensive care unit (ICU) could be associated with short-term mortality. METHODS: In this prospective observational cohort study, data from 4 ICUs in a University Hospital included SOFA scores on admission and day 4, along with preadmission measure
    Document: BACKGROUND: Identifying which octogenarians could benefit most from continuing critical care is challenging. We aimed to see if responses to therapies using the sequential organ failure assessment (SOFA) score on day 4 after unplanned admission to the intensive care unit (ICU) could be associated with short-term mortality. METHODS: In this prospective observational cohort study, data from 4 ICUs in a University Hospital included SOFA scores on admission and day 4, along with preadmission measurements of frailty, comorbidities, nutritional status and number of medications. Outcome measures included mortality and loss of autonomy on day 90 after admission. RESULTS: Eighty-seven critically ill patients aged 80 years or older with preadmission functional independence and no missing SOFA score data on day 4 were studied (primary analyses). The mortality rate on day 90 was 30%. In a univariate Cox model, the SOFA score on day 4 was significantly associated with mortality rate: hazard ratio = 1.18 per one-point increase, 95% confidence interval (CI), 1.08 to 1.28 (p<0.001). A SOFA score of 6 or more on day 4 could correctly classify 75% of patients who died on day 90, with a sensitivity of 54% and a specificity of 84%. After adjustment, the SOFA score on day 4, neurological failure on admission and the number of preadmission medications were significantly associated with mortality on day 90, with an area under the receiver operating characteristic curve of 0.81 (95% CI, 0.71 to 0.91). These findings were confirmed in a sensitivity analysis with 109 patients. Preadmission frailty was the only variable independently associated with loss of autonomy in the 49 surviving patients. CONCLUSION: Measuring SOFA score on day 4 and preadmission frailty could help predict mortality and loss of autonomy on day 90 in octogenarians after their acute admission to the ICU.

    Search related documents:
    Co phrase search for related documents
    • admission organ failure and logistic regression model: 1
    • admission prior and logistic cox: 1, 2
    • admission prior and logistic cox regression model: 1
    • admission prior and logistic regression analysis: 1, 2, 3, 4, 5, 6, 7, 8
    • admission prior and logistic regression model: 1, 2, 3, 4, 5
    • admission prior and long term death: 1, 2
    • admission prior and long term death risk: 1
    • admission prior and machine learning: 1, 2
    • admission second day and machine learning: 1
    • admission sofa score and logistic regression analysis: 1, 2, 3, 4
    • admission sofa score and logistic regression model: 1, 2, 3, 4
    • admission sofa score and logistic regression prediction: 1
    • admission sofa score and machine learning: 1, 2
    • logistic regression analysis and long term death: 1
    • logistic regression analysis and machine learning: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21
    • logistic regression model and long term death risk: 1
    • logistic regression model and machine learning: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55
    • logistic regression prediction and machine learning: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21
    • loss event and machine learning: 1