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Titolo:
Improved outcome of APACHE II score-defined escalating systemic inflammatory response syndrome in patients post cardiac surgery in 1996 compared to 1988-1990: the ESSICS-study pilot project
Autore:
Kuhn, C; Muller-Werdan, U; Schmitt, DV; Lange, H; Pilz, G; Kreuzer, E; Mohr, FW; Zerkowski, HR; Werdan, K;
Indirizzi:
Univ Halle Wittenberg, Dept Med 3, D-06097 Halle, Germany Univ Halle Wittenberg Halle Germany D-06097 ed 3, D-06097 Halle, Germany
Titolo Testata:
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
fascicolo: 1, volume: 17, anno: 2000,
pagine: 30 - 37
SICI:
1010-7940(200001)17:1<30:IOOAIS>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSTCARDIAC SURGICAL PATIENTS; CARDIOPULMONARY BYPASS; HIGH-RISK; VALVE-REPLACEMENT; EARLY PREDICTION; ORGAN FAILURE; SEPSIS; IMMUNOGLOBULINS; DEFINITIONS; INFECTIONS;
Keywords:
APACHE II score; cardiopulmonary bypass; escalating systemic inflammatory response syndrome; outcome after cardiac surgery; risk stratification;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Muller-Werdan, U Univ Halle Wittenberg, Dept Med 3, Ernst Grube Str 40, D-06097 Halle, Germany Univ Halle Wittenberg Ernst Grube Str 40 Halle Germany D-06097
Citazione:
C. Kuhn et al., "Improved outcome of APACHE II score-defined escalating systemic inflammatory response syndrome in patients post cardiac surgery in 1996 compared to 1988-1990: the ESSICS-study pilot project", EUR J CAR-T, 17(1), 2000, pp. 30-37

Abstract

Objective: Cardiac surgery using extracorporeal circulation leads to the release of cytokines and subsequently to a systemic inflammatory response syndrome, which is thought to be a negative prognostic factor for patients' outcome. A stratification for the risk of an escalating systemic inflammatory response syndrome had been achieved in a monocenter study carried out in 1988-1990, using APACHE II scoring on the morning of the Ist postoperative day. We now re-evaluated this concept prospectively in three independent centers. Methods: The APACHE II based risk stratification was put to test in three independent heart surgery centers in the period from June to December1996. Nine hundred and forty-five patients after elective cardiac surgery (excluding heart transplantation) with the assistance of the cardiopulmonary bypass were prospectively monitored. Results: We found an increase in mortality with higher ABACHE II score values determined on the ist postoperative day. The mortality rose to nearly 50% with an APACHE II score of greaterthan or equal to 28. Patients at high risk for the development of a systemic inflammatory response syndrome (APACHE II score greater than or equal to24) significantly differed from patients at lower risk (APACHE II score <19) in the duration of mechanical ventilation and extracorporeal circulation, age and New York Heart Association (NYHA) classification (P < 0.05). Conclusion: The APACHE II score determined on the morning of the Ist postoperative day helps identifying the subgroup of patients with escalating systemicinflammatory response syndrome. Comparison with the data obtained in the years 1988-1990, suggests a better prognosis in the current trial for patients at high risk with a similar degree of escalating systemic inflammatory response syndrome. (C) 2000 Elsevier Science B.V. All rights reserved.

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Documento generato il 29/09/20 alle ore 13:58:30