Articles: sepsis.
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J. Gastrointest. Surg. · Mar 2015
Multicenter StudyQuantifying the burden of complications following total pancreatectomy using the postoperative morbidity index: a multi-institutional perspective.
While contemporary studies demonstrate decreasing complication rates following total pancreatectomy (TP), none have quantified the impact of post-TP complications. The Postoperative Morbidity Index (PMI)-a quantitative measure of postoperative morbidity-combines ACS-NSQIP complication data with severity weighting derived from Modified Accordion Grading System. We establish the PMI for TP in a multi-institutional cohort. ⋯ This multi-institutional series is the first to quantify the complication burden following TP using the rigor of ACS-NSQIP. A PMI of 0.151 indicates that, collectively, patients undergoing TP have an average burden of complications in the mild to moderate severity range, although complication-bearing patients have a considerable reduction in health utility.
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Journal of critical care · Feb 2015
Multicenter Study Observational StudyAssociation between serum total antioxidant capacity and mortality in severe septic patients.
Total antioxidant capacity (TAC) in severe septic patients has been analyzed in few studies with limited number of subjects. In addition, no association between TAC serum levels and mortality in patients with sepsis has been investigated. We aimed at assessing a possible relationship between TAC serum levels and mortality using a large cohort of patients with severe sepsis. ⋯ The most relevant and new findings of our study, the largest cohort of septic patients providing data on circulating TAC levels so far, were that serum TAC levels are associated with mortality and could be used as biomarker to outcome prediction in severe septic patients.
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Intensive care medicine · Jan 2015
Randomized Controlled Trial Multicenter Study Observational StudyThromboelastography in patients with severe sepsis: a prospective cohort study.
To investigate the association between consecutively measured thromboelastographic (TEG) tracings and outcome in patients with severe sepsis. ⋯ In our cohort of patients with severe sepsis, progressive hypocoagulability defined by TEG variables was associated with increased risk of death and increased risk of bleeding.
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Randomized Controlled Trial Multicenter Study Observational Study
Association between biomarkers of endothelial injury and hypocoagulability in patients with severe sepsis: a prospective study.
Patients with severe sepsis often present with concurrent coagulopathy, microcirculatory failure and evidence of vascular endothelial activation and damage. Given the critical role of the endothelium in balancing hemostasis, we investigated single-point associations between whole blood coagulopathy by thrombelastography (TEG) and plasma/serum markers of endothelial activation and damage in patients with severe sepsis. ⋯ In our cohort of patients with severe sepsis, higher circulating levels of biomarkers of mainly endothelial damage were independently associated with hypocoagulability assessed by TEG and FF. Endothelial damage is intimately linked to coagulopathy in severe sepsis.
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Acta Anaesthesiol Scand · Jan 2015
Multicenter StudyPredictive value of NGAL for use of renal replacement therapy in patients with severe sepsis.
The predictive value of plasma and urine neutrophil gelatinase-associated lipocalin (NGAL) for use of renal replacement therapy (RRT) and acute kidney injury (AKI) is not established in patients with severe sepsis. ⋯ In ICU patients with severe sepsis, plasma and urine NGAL had low predictive power for use of RRT, AKI and 90-day mortality. These results were supported by sensitivity and exploratory analyses.