Inés Esmorís-Arijón1, Rita Galeiras2, Antonio Montoto Marqués3, Sonia Pértega Díaz4. 1. Critical Care Unit, Hospital Universitario Lucus Augusti, Lugo, Spain. ines.esmoris@gmail.com. 2. Critical Care Unit, Complexo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain. 3. Spinal Cord Injury Unit (SCIU), Phisiotherapy, Medicine and Biomedical Sciences Department, Complexo Hospitalario Universitario A Coruña, Universidade da Coruña, A Coruña, Spain. 4. Research Support Unit, Nursing and Healthcare Research Group, Rheumatology and Health Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña, A Coruña, Spain.
Abstract
STUDY DESIGN: This is a retrospective, observational study. OBJECTIVES: To evaluate organ dysfunction in patients with an acute traumatic spinal cord injury (ATSCI) above T6 using the Sequential Organ Failure Assessment (SOFA) score to determine its association with mortality. SETTING: The study was performed at the intensive care unit (ICU) of a tertiary hospital in the northwest of Spain. METHODS: The study included 241 patients with an ATSCI above T6 who had been admitted to the ICU between 1998 and 2017. A descriptive analysis of all variables collected was performed to compare the survivors with the non-survivors. In addition, a logistic regression model was used in the multivariate analysis to identify variables that were independently associated with mortality. RESULTS: The results revealed significant differences between the survivors and non-survivors in terms of their age, Charlson Comorbidity Index, Glasgow Coma Scale score on admission, APACHE II score, SOFA score on day 0 and day 4, and delta SOFA 4-0 (ΔSOFA 4-0). The results of this multivariate analysis identified the following variables as independent predictors of intra-ICU mortality: age (OR = 1.05; 95% CI: 1. 01-1.08), SOFA score on day 0 (OR = 1.42; 95% CI: 1.13-1.78), ΔSOFA 4-0 (OR = 1.53; 95% CI: 1.25-1.87), and fluid balance on day 4 (OR = 1.16; 95% CI: 1.00-1.35). CONCLUSIONS: The SOFA score is useful for evaluating organ dysfunction in patients with an ATSCI above T6. After adjusting the analysis for conventional variables, organ dysfunction on admission, changes in organ function between day 4 and day 0 (ΔSOFA 4-0), and fluid balance on day 4 were seen to be independently associated with mortality in our study.
STUDY DESIGN: This is a retrospective, observational study. OBJECTIVES: To evaluate organ dysfunction in patients with an acute traumatic spinal cord injury (ATSCI) above T6 using the Sequential Organ Failure Assessment (SOFA) score to determine its association with mortality. SETTING: The study was performed at the intensive care unit (ICU) of a tertiary hospital in the northwest of Spain. METHODS: The study included 241 patients with an ATSCI above T6 who had been admitted to the ICU between 1998 and 2017. A descriptive analysis of all variables collected was performed to compare the survivors with the non-survivors. In addition, a logistic regression model was used in the multivariate analysis to identify variables that were independently associated with mortality. RESULTS: The results revealed significant differences between the survivors and non-survivors in terms of their age, Charlson Comorbidity Index, Glasgow Coma Scale score on admission, APACHE II score, SOFA score on day 0 and day 4, and delta SOFA 4-0 (ΔSOFA 4-0). The results of this multivariate analysis identified the following variables as independent predictors of intra-ICU mortality: age (OR = 1.05; 95% CI: 1. 01-1.08), SOFA score on day 0 (OR = 1.42; 95% CI: 1.13-1.78), ΔSOFA 4-0 (OR = 1.53; 95% CI: 1.25-1.87), and fluid balance on day 4 (OR = 1.16; 95% CI: 1.00-1.35). CONCLUSIONS: The SOFA score is useful for evaluating organ dysfunction in patients with an ATSCI above T6. After adjusting the analysis for conventional variables, organ dysfunction on admission, changes in organ function between day 4 and day 0 (ΔSOFA 4-0), and fluid balance on day 4 were seen to be independently associated with mortality in our study.
Authors: Victor J Hassid; Miren A Schinco; Joseph J Tepas; Margaret M Griffen; Terri L Murphy; Eric R Frykberg; Andrew J Kerwin Journal: J Trauma Date: 2008-12