Prospectively validated predictions of shock and organ failure in individual septic surgical patients the Systemic Mediator Associated Response Test 英文参考文献.docVIP

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Prospectively validated predictions of shock and organ failure in individual septic surgical patients the Systemic Mediator Associated Response Test 英文参考文献.doc

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Prospectively validated predictions of shock and organ failure in individual septic surgical patients the Systemic Mediator Associated Response Test 英文参考文献

/content/4/5/319 Primary research Prospectively validated predictions of shock and organ failure in individual septic surgical patients: the Systemic Mediator Associated Response Test Gus J Slotman University of Medicine and Dentistry of New Jersey, Camden, New Jersey, USA Received: 23 December 1999 2000 Revisions requested: 16 May 2000 Revisions received: 17 July 2000 Accepted: 31 July 2000 Crit Care 2000, 4:319–326 The electronic version of this article can be found online at /content/4/5/319 Published: 8 September 2000 ? Current Science Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X) Abstract Introduction: Clinically useful predictions of end-organ function and failure in severe sepsis may be possible through analyzing the interactions among demographics, physiologic parameters, standard laboratory tests, and circulating markers of inflammation. The present study evaluated the ability of such a methodology, the Systemic Mediator Associated Response Test (SMART), to predict the clinical course of septic surgery patients from a database of medical and surgical patients with severe sepsis and/or septic shock. Patients and methods: Three hundred and three patients entered into the placebo arm of a multi-institutional sepsis study were randomly assigned to a model-building cohort (n = 200; 119 surgical) or to a predictive cohort (n = 103; 55 surgical). Using baseline and baseline plus serial measurements of physiologic data, standard laboratory tests, and plasma levels of IL-6, IL-8, and granulocyte colony-stimulating factor (GCSF), multivariate models were developed that predicted the presence or absence of pulmonary edema on chest radiography, and respiratory, renal, coagulation, hepatobiliary, or central nervous system dysfunction and shock in individual patients. Twenty-eight-day survival was predicted also in baseline plus serial data models. These models were validated prospectively by