tailieunhanh - Báo cáo y học: "Organ failure and tight glycemic control in the SPRINT study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Organ failure and tight glycemic control in the SPRINT study. | Chase et al. Critical Care 2010 14 R154 http content 14 4 R154 c CRITICAL CARE RESEARCH Open Access Organ failure and tight glycemic control in the SpRiNT study 1 12 3 4 J Geoffrey Chase Christopher G Pretty Leesa Pfeifer Geoffrey M Shaw Jean-Charles Preiser Aaron J Le Compte1 Jessica Lin2 Darren Hewett1 Katherine T Moorhead Thomas Desaive5 Abstract Introduction Intensive care unit mortality is strongly associated with organ failure rate and severity. The sequential organ failure assessment SOFA score is used to evaluate the impact of a successful tight glycemic control TGC intervention SPRINT on organ failure morbidity and thus mortality. Methods A retrospective analysis of 371 patients 3 356 days on SPRINT August 2005 - April 2007 and 413 retrospective patients 3 211 days from two years prior matched by Acute Physiology and Chronic Health Evaluation APACHE III. SOFA is calculated daily for each patient. The effect of the SPRINT TGC intervention is assessed by comparing the percentage of patients with SOFA 5 each day and its trends over time and cohort group. Organ-failure free days all SOFA components 2 and number of organ failures SOFA components 2 are also compared. Cumulative time in to mmol L band cTIB was evaluated daily to link tightness and consistency of TGC cTIB to SOFA 5 using conditional and joint probabilities. Results Admission and maximum SOFA scores were similar P P with similar time to maximum median one day IQR 1 3 days P . Median length of stay was similar days SPRINT and days PreSPRINT P . The percentage of patients with SOFA 5 is different over the first 14 days P rising to approximately 75 for Pre-SPRINT and approximately 85 for SPRINT with clear separation after two days. Organfailure-free days were different SPRINT Pre-SPRINT P as were the percent of total possible organ failures SPRINT Pre-SPRINT P . By Day 3 over 90 of SPRINT patients had cTIB