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Association of Clinical Hypoperfusion Variables With Lactate Clearance and Hospital Mortality / Jessica María Londoño Agudelo ; Elisa Bernal Sierra ; Fabián Alberto Jaimes Barragán  

Público ISBD Título : Association of Clinical Hypoperfusion Variables With Lactate Clearance and Hospital Mortality Tipo de documento : documento electrónico Autores : Jessica María Londoño Agudelo, ; Elisa Bernal Sierra, ; Fabián Alberto Jaimes Barragán, Fecha de publicación : 2018 Títulos uniformes : Shock Idioma : Inglés (eng) Palabras clave : Hyperlactatemia  lactic acid  multiple trauma  oxygen consumption  patient outcome assessment  resuscitation  sepsis  shock  vasopressors Resumen : Background: Lactate has shown utility in assessing the prognosis of patients admitted to the hospital with confirmed or suspected shock. Some findings of the physical examination may replace it as screening tool. We have determined the correlation and association between clinical perfusion parameters and lactate at the time of admission; the correlation between the change in clinical parameters and lactate clearance after 6 and 24 h of resuscitation; and the association between clinical parameters, lactate, and mortality. Methods: Prospective cohort study of adult patients hospitalized in the emergency room with infection, polytrauma, or other causes of hypotension. We measured serum lactate, capillary refill time, shock index, and pulse pressure at 0, 6, and 24 h after admission. A Spearman's correlation was performed between clinical variables and lactate levels, as well as between changes in clinical parameters and lactate clearance. The operative characteristics of these variables were determined by area under the receiver operating characteristic curve analysis and the association between lactate, clinical variables, and mortality through logistic regression. Results: A total of 1,320 patients met the inclusion criteria, 66.7% (n = 880) confirmed infection, 19% (n = 251) polytrauma, and 14.3% (n = 189) another etiology. No significant correlation was found between any clinical variable and lactate values (r Mención de responsabilidad : Jessica Londoño, César Niño, James Díaz, Carlos Morales, Jimmy León, Elisa Bernal, Cesar Vargas, Leonardo Mejía, Carolina Hincapié, Johana Ascuntar, Alba León, Fabián Jaimes Referencia : Shock. 2018 Sep;50(3):286-292. DOI (Digital Object Identifier) : 10.1097/SHK.0000000000001066 PMID : 29206763 En línea : https://journals.lww.com/shockjournal/fulltext/2018/09000/Association_of_Clinica [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4199 Association of Clinical Hypoperfusion Variables With Lactate Clearance and Hospital Mortality [documento electrónico] / Jessica María Londoño Agudelo, ; Elisa Bernal Sierra, ; Fabián Alberto Jaimes Barragán,  . - 2018. Obra : Shock Idioma : Inglés (eng) Palabras clave : Hyperlactatemia  lactic acid  multiple trauma  oxygen consumption  patient outcome assessment  resuscitation  sepsis  shock  vasopressors Resumen : Background: Lactate has shown utility in assessing the prognosis of patients admitted to the hospital with confirmed or suspected shock. Some findings of the physical examination may replace it as screening tool. We have determined the correlation and association between clinical perfusion parameters and lactate at the time of admission; the correlation between the change in clinical parameters and lactate clearance after 6 and 24 h of resuscitation; and the association between clinical parameters, lactate, and mortality. Methods: Prospective cohort study of adult patients hospitalized in the emergency room with infection, polytrauma, or other causes of hypotension. We measured serum lactate, capillary refill time, shock index, and pulse pressure at 0, 6, and 24 h after admission. A Spearman's correlation was performed between clinical variables and lactate levels, as well as between changes in clinical parameters and lactate clearance. The operative characteristics of these variables were determined by area under the receiver operating characteristic curve analysis and the association between lactate, clinical variables, and mortality through logistic regression. Results: A total of 1,320 patients met the inclusion criteria, 66.7% (n = 880) confirmed infection, 19% (n = 251) polytrauma, and 14.3% (n = 189) another etiology. No significant correlation was found between any clinical variable and lactate values (r Mención de responsabilidad : Jessica Londoño, César Niño, James Díaz, Carlos Morales, Jimmy León, Elisa Bernal, Cesar Vargas, Leonardo Mejía, Carolina Hincapié, Johana Ascuntar, Alba León, Fabián Jaimes Referencia : Shock. 2018 Sep;50(3):286-292. DOI (Digital Object Identifier) : 10.1097/SHK.0000000000001066 PMID : 29206763 En línea : https://journals.lww.com/shockjournal/fulltext/2018/09000/Association_of_Clinica [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4199

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Validation of trauma scales: ISS, NISS, RTS and TRISS for predicting mortality in a Colombian population / Carlos Oliver Valderrama Molina ; Nelson Darío Giraldo Ramírez ; Alfredo Constain Franco ; Jaime Andrés Puerta Gómez ; Fabián Alberto Jaimes Barragán  

Público ISBD Título : Validation of trauma scales: ISS, NISS, RTS and TRISS for predicting mortality in a Colombian population Tipo de documento : documento electrónico Autores : Carlos Oliver Valderrama Molina, ; Nelson Darío Giraldo Ramírez, ; Alfredo Constain Franco, ; Jaime Andrés Puerta Gómez, ; Fabián Alberto Jaimes Barragán, Fecha de publicación : 2017 Títulos uniformes : European Journal of Orthopaedic Surgery & Traumatology Idioma : Inglés (eng) Palabras clave : Trauma Severity Indices  multiple trauma  mortality Resumen : Background: Our purpose was to validate the performance of the ISS, NISS, RTS and TRISS scales as predictors of mortality in a population of trauma patients in a Latin American setting. Materials and methods: Subjects older than 15 years with diagnosis of trauma, lesions in two or more body areas according to the AIS and whose initial attention was at the hospital in the first 24 h were included. The main outcome was inpatient mortality. Secondary outcomes were admission to the intensive care unit, requirement of mechanical ventilation and length of stay. A logistic regression model for hospital mortality was fitted with each of the scales as an independent variable, and its predictive accuracy was evaluated through discrimination and calibration statistics. Results: Between January 2007 and July 2015, 4085 subjects were enrolled in the study. 84.2% (n = 3442) were male, the mean age was 36 years (SD = 16), and the most common trauma mechanism was blunt type (80.1%; n = 3273). The medians of ISS, NISS, TRISS and RTS were: 14 (IQR = 10–21), 17 (IQR = 11–27), 4.21 (IQR = 2.95–5.05) and 7.84 (IQR = 6.90–7.84), respectively. Mortality was 9.3%, and the discrimination for ISS, NISS, TRISS and RTS was: AUC 0.85, 0.89, 0.86 and 0.92, respectively. No one scale had appropriate calibration. Conclusion: Determining the severity of trauma is an essential tool to guide treatment and establish the necessary resources for attention. In a Colombian population from a capital city, trauma scales have adequate performance for the prediction of mortality in patients with trauma. Mención de responsabilidad : Carlos Oliver Valderrama-Molina, Nelson Giraldo, Alfredo Constain, Andres Puerta, Camilo Restrepo, Alba León, Fabián Jaimes Referencia : Eur J Orthop Surg Traumatol. 2017 Feb;27(2):213-220. DOI (Digital Object Identifier) : 10.1007/s00590-016-1892-6 PMID : 27999959 En línea : https://link.springer.com/article/10.1007%2Fs00590-016-1892-6 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4042 Validation of trauma scales: ISS, NISS, RTS and TRISS for predicting mortality in a Colombian population [documento electrónico] / Carlos Oliver Valderrama Molina, ; Nelson Darío Giraldo Ramírez, ; Alfredo Constain Franco, ; Jaime Andrés Puerta Gómez, ; Fabián Alberto Jaimes Barragán,  . - 2017. Obra : European Journal of Orthopaedic Surgery & Traumatology Idioma : Inglés (eng) Palabras clave : Trauma Severity Indices  multiple trauma  mortality Resumen : Background: Our purpose was to validate the performance of the ISS, NISS, RTS and TRISS scales as predictors of mortality in a population of trauma patients in a Latin American setting. Materials and methods: Subjects older than 15 years with diagnosis of trauma, lesions in two or more body areas according to the AIS and whose initial attention was at the hospital in the first 24 h were included. The main outcome was inpatient mortality. Secondary outcomes were admission to the intensive care unit, requirement of mechanical ventilation and length of stay. A logistic regression model for hospital mortality was fitted with each of the scales as an independent variable, and its predictive accuracy was evaluated through discrimination and calibration statistics. Results: Between January 2007 and July 2015, 4085 subjects were enrolled in the study. 84.2% (n = 3442) were male, the mean age was 36 years (SD = 16), and the most common trauma mechanism was blunt type (80.1%; n = 3273). The medians of ISS, NISS, TRISS and RTS were: 14 (IQR = 10–21), 17 (IQR = 11–27), 4.21 (IQR = 2.95–5.05) and 7.84 (IQR = 6.90–7.84), respectively. Mortality was 9.3%, and the discrimination for ISS, NISS, TRISS and RTS was: AUC 0.85, 0.89, 0.86 and 0.92, respectively. No one scale had appropriate calibration. Conclusion: Determining the severity of trauma is an essential tool to guide treatment and establish the necessary resources for attention. In a Colombian population from a capital city, trauma scales have adequate performance for the prediction of mortality in patients with trauma. Mención de responsabilidad : Carlos Oliver Valderrama-Molina, Nelson Giraldo, Alfredo Constain, Andres Puerta, Camilo Restrepo, Alba León, Fabián Jaimes Referencia : Eur J Orthop Surg Traumatol. 2017 Feb;27(2):213-220. DOI (Digital Object Identifier) : 10.1007/s00590-016-1892-6 PMID : 27999959 En línea : https://link.springer.com/article/10.1007%2Fs00590-016-1892-6 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4042

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