Predictors of Lethal Outcomes in Patients with Refractory Septic Shock
Early prediction of disease severity helps clinicians prevent adverse events and/or minimize losses in the event of a life-threatening complication. This provision fully applies to refractory septic shock, in which norepinephrine administration at a dose exceeding 0.5 μg/kg-1/min-1 is needed to main...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | Russian |
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New Terra Publishing House
2021-07-01
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| Series: | Вестник анестезиологии и реаниматологии |
| Subjects: | |
| Online Access: | https://www.vair-journal.com/jour/article/view/536 |
| _version_ | 1797700369992646656 |
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| author | А. А. Kochkin M. Ya. Yadgarov L. B. Berikashvili S. N. Perekhodov V. V. Likhvantsev |
| author_facet | А. А. Kochkin M. Ya. Yadgarov L. B. Berikashvili S. N. Perekhodov V. V. Likhvantsev |
| author_sort | А. А. Kochkin |
| collection | DOAJ |
| description | Early prediction of disease severity helps clinicians prevent adverse events and/or minimize losses in the event of a life-threatening complication. This provision fully applies to refractory septic shock, in which norepinephrine administration at a dose exceeding 0.5 μg/kg-1/min-1 is needed to maintain mean arterial pressure.The objective: to determine predictors of lethal outcomes in patients with refractory septic shock.Subjects and methods. A retrospective study included 79 patients with refractory septic shock aged from 42 to 74 years (59.7 ± 7.8), with severity of the condition as per SOFA varying from 8 to 16 scores. The predictive value of indicators was assessed using univariate and multivariate analyses.Results. In multivariate analysis, the only significant predictor of an unfavorable outcome was the SOFA score (adj. OR: 1.626 [95% CI: 1.313; 2.014], p < 0.001). Other putative indicators (age, oxygenation index, lactate and procalcitonin concentrations, and norepinephrine dose) had no predictive value.Conclusion: The SOFA score is an independent predictor of lethality in adult patients with refractory septic shock (аdj. OR: 1.26 [95% CI: 1.313; 2.014], p < 0.001). According to the results of the ROC analysis, along with SOFA, norepinephrine dose was also a significant predictor (AUC 0.989 [95% CI 0.934; 1.000], p < 0.001). |
| first_indexed | 2024-03-12T04:20:48Z |
| format | Article |
| id | doaj.art-5119f9c385f4473eb439b9f47b6600cf |
| institution | Directory Open Access Journal |
| issn | 2078-5658 2541-8653 |
| language | Russian |
| last_indexed | 2024-03-12T04:20:48Z |
| publishDate | 2021-07-01 |
| publisher | New Terra Publishing House |
| record_format | Article |
| series | Вестник анестезиологии и реаниматологии |
| spelling | doaj.art-5119f9c385f4473eb439b9f47b6600cf2023-09-03T10:33:10ZrusNew Terra Publishing HouseВестник анестезиологии и реаниматологии2078-56582541-86532021-07-01183303510.21292/2078-5658-2021-18-3-30-35447Predictors of Lethal Outcomes in Patients with Refractory Septic ShockА. А. Kochkin0M. Ya. Yadgarov1L. B. Berikashvili2S. N. Perekhodov3V. V. Likhvantsev4Московский областной научно-исследовательский клинический институт им. М. Ф. ВладимирскогоНИИ Общей реаниматологии им. В. А. Неговского ФНКЦ РРНИИ Общей реаниматологии им. В. А. Неговского ФНКЦ РРМосковский государственный медико-стоматологический университет им. А. И. ЕвдокимоваМосковский областной научно-исследовательский клинический институт им. М. Ф. Владимирского; НИИ Общей реаниматологии им. В. А. Неговского ФНКЦ РРEarly prediction of disease severity helps clinicians prevent adverse events and/or minimize losses in the event of a life-threatening complication. This provision fully applies to refractory septic shock, in which norepinephrine administration at a dose exceeding 0.5 μg/kg-1/min-1 is needed to maintain mean arterial pressure.The objective: to determine predictors of lethal outcomes in patients with refractory septic shock.Subjects and methods. A retrospective study included 79 patients with refractory septic shock aged from 42 to 74 years (59.7 ± 7.8), with severity of the condition as per SOFA varying from 8 to 16 scores. The predictive value of indicators was assessed using univariate and multivariate analyses.Results. In multivariate analysis, the only significant predictor of an unfavorable outcome was the SOFA score (adj. OR: 1.626 [95% CI: 1.313; 2.014], p < 0.001). Other putative indicators (age, oxygenation index, lactate and procalcitonin concentrations, and norepinephrine dose) had no predictive value.Conclusion: The SOFA score is an independent predictor of lethality in adult patients with refractory septic shock (аdj. OR: 1.26 [95% CI: 1.313; 2.014], p < 0.001). According to the results of the ROC analysis, along with SOFA, norepinephrine dose was also a significant predictor (AUC 0.989 [95% CI 0.934; 1.000], p < 0.001).https://www.vair-journal.com/jour/article/view/536септический шокпредикторы летальности при септическом шокерефрактерный шок |
| spellingShingle | А. А. Kochkin M. Ya. Yadgarov L. B. Berikashvili S. N. Perekhodov V. V. Likhvantsev Predictors of Lethal Outcomes in Patients with Refractory Septic Shock Вестник анестезиологии и реаниматологии септический шок предикторы летальности при септическом шоке рефрактерный шок |
| title | Predictors of Lethal Outcomes in Patients with Refractory Septic Shock |
| title_full | Predictors of Lethal Outcomes in Patients with Refractory Septic Shock |
| title_fullStr | Predictors of Lethal Outcomes in Patients with Refractory Septic Shock |
| title_full_unstemmed | Predictors of Lethal Outcomes in Patients with Refractory Septic Shock |
| title_short | Predictors of Lethal Outcomes in Patients with Refractory Septic Shock |
| title_sort | predictors of lethal outcomes in patients with refractory septic shock |
| topic | септический шок предикторы летальности при септическом шоке рефрактерный шок |
| url | https://www.vair-journal.com/jour/article/view/536 |
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