Κατεύθυνση Κλινική Νοσηλευτική: Εντατική και Επείγουσα ΝοσηλευτικήLibrary of the School of Health Sciences
Κατσούλας Θεόδωρος, Επίκουρος Καθηγητής, Νοσηλευτική, ΕΚΠΑ
Φιλντίσης Γεώργιος, Καθηγητής, Νοσηλευτική, ΕΚΠΑ
Κωνσταντίνου Ευάγγελος, Καθηγητής, Νοσηλευτική, ΕΚΠΑ
Συσχέτιση της C- αντιδρώσας πρωτεΐνης με το SOFA score στη χρονική εξέλιξη της σήψης και η προγνωστική αξία των μεταβολών τους
The corellation of CRP with the SOFA score in sepsi's time revolution and the preventive value of their changes
Introduction- Background : Sepsis is a systematic disease which characterized by increased morbidity and mortality rates for the critical illness patients. It’s complicated pathophysiology in relation with it’s non typical clinical icon and the lack of reliable tools, are reasons that make it a difficult problem to be solved in health. It is that which leads to the increase of patient’s lenght of stay and of the cost in and out of ICU.
Aim: The aim of this research is to be shown if the laboratory results, by measuring the CRP, meet the clinical criteria, by calculating the SOFA score and if this can be used as a prognostic tool of the patient’s health. A second purpose is the mortality to be calculated and to be shown the factors from which the mortality is up.
Methodology: An observed retroactive research took place in the University ICU of General Oncologist Ηospital of Athens “ Agioi Anargyroi”, from January of 2016 to June of 2017. 37 medical folders of patients who had one septic episode at least in their stay in ICU, were exhaustively studied . So, 52 septic episodes were presented in detail. The main biomarker recorded, was CRP and the SOFA score was decording every 48 hours during the whole patient’s stay in ICU. Finally, the mortality was calculated and the factors which play a significant role in this, were shown.
Results: From the data statistical analysis it is be shown that the mean age of patients with sepsis was 71.16±8.82 and the mean length of stay was 45.41±31.572 days. 27 of them were men and 10 were women. Twenty one patients died and 16 were alive. Twenty seven patients had just one septic episode , seven patients ha two septic episodes, two patients had three episodes and only a patient had five same episodes. As the number of septic episodes were increased, so did the mortality rate too. The median length of an episode was seven days, while the mean variation SOFA score was was 2.5. The gram(-) bacterials were the main reasons which provoked a septic episode. The most significant of them were pseudomonas, klebsiella and acinetobacter, which provoked infections in the blood firstly (65.4%) and in the bronchial secretions secondly (34.6%). The relation between SOFA score and CRP was statistically studied by Spearman and seemed to be analogical ( p=0.021).
Conclusions: The correlation between SOFA score and CRP seems to be positive and the connection of these two can reflect the seriousness of the patient’s health and can be a prognostic tool. However, given the fact that the perfect biomarker does not exist in order sepsis be diagnosed immediately, more research has to take place which is better to expand to other fields too, as this of genetics.
Main subject category:
Sepsis biomarkers, Management of sepsis, ICU infections
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