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Titolo:
EARLY IDENTIFICATION OF PATIENTS AT RISK FOR SEPSIS FOLLOWING CARDIAC-SURGERY
Autore:
PILZ G; KAAB S; KREUZER E; WERDAN K;
Indirizzi:
UNIV MUNICH,KLINIKUM GROSSHADERN,MED KLIN 1,MARCHIONINISTR 15 W-8000 MUNICH 70 GERMANY UNIV MUNICH,KLINIKUM GROSSHADERN,HERZCHIRURG KLIN W-8000 MUNICH 70 GERMANY
Titolo Testata:
Infusionstherapie und Transfusionsmedizin
, volume: 20, anno: 1993, supplemento:, 1
pagine: 6 - 15
SICI:
1019-8466(1993)20:<6:EIOPAR>2.0.ZU;2-V
Fonte:
ISI
Lingua:
GER
Soggetto:
MULTIPLE-ORGAN FAILURE; APACHE-II; SEPTIC SHOCK; CARDIOPULMONARY BYPASS; SURGICAL PATIENTS; NORMAL HUMANS; SEVERITY; SCORES; OPERATIONS; GENERATION;
Keywords:
APACHE-II SCORE; CARDIAC SURGERY; ELASTASE; NEOPTERIN; SEPSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
40
Recensione:
Indirizzi per estratti:
Citazione:
G. Pilz et al., "EARLY IDENTIFICATION OF PATIENTS AT RISK FOR SEPSIS FOLLOWING CARDIAC-SURGERY", Infusionstherapie und Transfusionsmedizin, 20, 1993, pp. 6-15

Abstract

Since sepsis is a major cause of mortality after cardiac surgery, early identification of the patients at risk of developing septic complications is of considerable importance. In the present study on 110 patients after elective heart surgery, we, therefore, examined scoring systems as well as various single parameters with regard to an early prediction of septic complications. In a first step, the Elebute score definition for post-operative sepsis in general surgery patients (score greater-than-or-equal-to 12) could be confirmed for cardiac surgery patients as well. Septic complications, defined as an Elebute score greater-than-or-equal-to 12 on greater-than-or-equal-to 2 days, occurred in16 patients and were associated with a significantly worse prognosis than in non-septic patients (mortality 69 vs. 1%). Consequently, othermore practicable parameters were investigated: five additional scores(APACHE II, Goris, HIS, SAPS, SSS) were.comparable and superior to plasma levels of elastase and neopterin, haemodynamic data, and clinicalparameters in predicting septic complications as early as by the lst postoperative day. For reasons of practicability and availability, theAPACHE II score (predictive values: positive 86%, negative 96%, Youden index 0.73; diagnostic cut off point: greater-than-or-equal-to 19 onthe 1st postoperative day) seemed to be best suited. Therefore, this was further investigated within a consecutive prospective study (independent group of 106 patients) which confirmed an APACHE II score greater-than-or-equal-to 19 as discriminating criterion (mortality 36 vs 0%). Thus, the APACHE II score may be useful for prospective screening, with the intention to treat, of patients after cardiac surgery who areat risk of postoperative septic complications.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/09/20 alle ore 14:19:07