Single Deranged Physiologic Parameters Are Associated With Mortality in a Low-Income Country

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Single Deranged Physiologic Parameters Are Associated With Mortality in a Low-Income Country

Baker, Tim (författare): Karolinska Institutet

Blixt, Jonas (författare): Karolinska Institutet

Lugazia, Edwin (författare): Muhimbili Univ Hlth & Allied Sci, Dept Anaesthesia & Intens Care, Dar Es Salaam, Tanzania.

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Schell, Carl Otto (författare): Karolinska Institutet,Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD),Sormland Cty Council, Nykoping Hosp, Dept Internal Med, Nykoping, Sweden.

Mulungu, Moses (författare): Karolinska Institutet

Milton, Anna (författare): Karolinska Institutet

Castegren, Markus (författare): Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD)

Eriksen, Jaran (författare): Karolinska Institutet

Konrad, David (författare): Karolinska Institutet

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Karolinska Institutet Muhimbili Univ Hlth & Allied Sci, Dept Anaesthesia & Intens Care, Dar Es Salaam, Tanzania (creator_code:org_t)

2015
2015
Engelska.
Ingår i: Critical Care Medicine. - 0090-3493 .- 1530-0293. ; 43:10, s. 2171-2179

Relaterad länk:: https://urn.kb.se/re...; visa fler...; https://doi.org/10.1...; http://kipublication...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

Objective: To investigate whether deranged physiologic parameters at admission to an ICU in Tanzania are associated with in-hospital mortality and compare single deranged physiologic parameters to a more complex scoring system. Design: Prospective, observational cohort study of patient notes and admission records. Data were collected on vital signs at admission to the ICU, patient characteristics, and outcomes. Cutoffs for deranged physiologic parameters were defined a priori and their association with in-hospital mortality was analyzed using multivariable logistic regression. Setting: ICU at Muhimbili National Hospital, Dar es Salaam, Tanzania. Patients: All adults admitted to the ICU in a 15-month period. Measurements and Main Results: Two hundred sixty-nine patients were included: 54% female, median age 35 years. In-hospital mortality was 50%. At admission, 69% of patients had one or more deranged physiologic parameter. Sixty-four percent of the patients with a deranged physiologic parameter died in hospital compared with 18% without (p < 0.001). The presence of a deranged physiologic parameter was associated with mortality (adjusted odds ratio, 4.64; 95% CI, 1.95-11.09). Mortality increased with increasing number of deranged physiologic parameters (odds ratio per deranged physiologic parameter, 2.24 [1.53-3.26]). Every individual deranged physiologic parameter was associated with mortality with unadjusted odds ratios between 1.92 and 16.16. A National Early Warning Score of greater than or equal to 7 had an association with mortality (odds ratio, 2.51 [1.23-5.14]). Conclusion: Single deranged physiologic parameters at admission are associated with mortality in a critically ill population in a low-income country. As a measure of illness severity, single deranged physiologic parameters are as useful as a compound scoring system in this setting and could be termed danger signs. Danger signs may be suitable for the basis of routines to identify and treat critically ill patients.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)

Nyckelord

critical care
developing countries
global health
hospital mortality
quality of health care
vital signs

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art (ämneskategori)

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Av författaren/redakt...: Baker, Tim; Blixt, Jonas; Lugazia, Edwin; Schell, Carl Ott ...; Mulungu, Moses; Milton, Anna; visa fler...; Castegren, Marku ...; Eriksen, Jaran; Konrad, David; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin

Artiklar i publikationen: Critical Care Me ...

Av lärosätet: Uppsala universitet; Karolinska Institutet

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