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Prognostic Value of Estimated Plasma Volume Status in Patients With Sepsis

Cited 7 time in Web of Science Cited 7 time in Scopus
Authors

Kim, Kyung Hoon; Cho, Hyeong Jun; Kim, Seok Chan; Lee, Jongmin

Issue Date
2022-05
Publisher
대한의학회
Citation
Journal of Korean Medical Science, Vol.37 No.18, p. e145
Abstract
Background: In patients with sepsis, timely risk stratification is important to improve prognosis. Although several clinical scoring systems are currently being used to predict the outcome of sepsis, but they all have certain limitations. The objective of this study was to evaluate the prognostic value of estimated plasma volume status (ePVS) in patients admitted to the intensive care unit (ICU) with sepsis or septic shock. Methods: This single-center, prospective observational study, included 100 patients admitted to the ICU with sepsis or septic shock. Informed consent, blood samples, and co-morbidity data were obtained from the patients on admission, and the severity of sepsis was recorded. The primary outcome was in-hospital mortality and multivariable logistic regression analysis was used to adjust for confounding factors to determine the significant prognostic factor. Results: The in-hospital mortality was 47%. The ePVS was correlated with the amount of total fluids administered 24 hours before the ICU admission. The mean ePVS in patients who died was higher than in those who survived (7.7 ± 2.1 dL/g vs. 6.6 ± 1.6 dL/g, P= 0.003). To evaluate the utility of ePVS in predicting in-hospital mortality, a receiver operating characteristic curve was produced. Sensitivity and specificity were optimal at a cut-off point of 7.09 dL/g, with an area under the curve of 0.655. In the multivariate analysis, higher ePVS was significantly associated with higher in-hospital mortality (adjusted odds ratio, 1.39; 95% confidence interval, 1.04–1.85, P= 0.028). The Kaplan-Meier curve showed that an ePVS value above 7.09 was associated with an increased risk of in-hospital mortality compared with the rest of the population (P= 0.004). Conclusion: The ePVS was correlated with the amount of intravenous fluid resuscitation and may be used as a simple and novel prognostic factor in patients with sepsis or septic shock who are admitted to the ICU.
ISSN
1011-8934
URI
https://hdl.handle.net/10371/201600
DOI
https://doi.org/10.3346/jkms.2022.37.e145
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  • College of Medicine
  • Department of Medicine
Research Area 식품알레르기, 아토피피부염, 천식

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