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ISSN 1995-9494 (Electronic)
Revista del Hospital Clínico Quirúrgico "Arnaldo Milián Castro"

2015, Number 4

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Acta Med Cent 2015; 9 (4)

Nueva escala de severidad del daño hepático por sepsis

Rodríguez RJM, Consuegra CAN, Montero GTJ, Ygualada CIP

Language: Spanish
References: 20
Page: 4-12
PDF size: 244.25 Kb.


ABSTRACT

Sepsis has high mortality, early affects the liver, specialists in Intensive Care and Emergency tools used to predict patient outcomes. Objective: To design a scale to unify criteria for the diagnosis of the severity of liver damage from sepsis. Methods: Retrospective, observational, descriptive 200 deaths from sepsis study; liver histological patterns and epidemiological and clinical variables were determined and a scale was designed to assess the severity of liver injury in sepsis, which was validated internally. Results: liver damage was classified as severe and not severe, severe was three times higher in patients with non-white skin color and 17 times higher in patients with APACHE II (mortality risk) greater than 76% and abdominal infection; the best model identified severe liver damage with accuracy of 89.5%, sensitivity of 97.6% and specificity of 52.8% and the area under the receiver operating characteristic curve was 0.78, with a statistic significance associated with less than 0.01 calculated and predicted better that chance, with confidence interval from 0.71 to 0.85. Conclusions: The model had high sensitivity, better identified severe liver damage and predicted better than chance.


REFERENCES

  1. Angus DC, Van der Poll T. Severe sepsis and septic shock. N Engl J Med [Internet]. 2013 [citado 12 Jun 2014];369:840-51. Disponible en: http://www.nejm.org/doi/full/10.1056/NEJMra1208623

  2. León C, Loza A. Biomarcadores en la sepsis. ¿Simplificando lo complejo? Enferm Infecc Microbiol Clin [Internet]. 2014 Mar [citado 12 Jun 2014];32(3):137-139. Disponible en: http://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-biomarcadores-sepsis-simplificando-lo-complejo-90275513

  3. González Lisorge A. Estudio sobre la sepsis grave de origen abdominal. Utilidad de la procalcitonina y otros marcadores pronósiticos [tesis]. España: Universidad de Murcia [Internet]. 2013 Dic [citado 27 Feb 2014]. Disponible en: http://www.tdx.cat/handle/10803/128673

  4. Gómez Tello V. El hígado en la sepsis. Rev Electrón Med Inten [Internet]. 2004 [citado 12 Jun 2014];4(12):[aprox. 24 p.]. Disponible en: http://remi.uninet.edu/2004/12/REMIC23.htm

  5. Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med [Internet]. 1996 [citado 12 Jun 2014];22(7):707-10. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/8844239

  6. Evaluation for severe sepsis screening tool [Internet]. © 2005 [citado 12 May 2014]. Surviving Sepsis Campaign [aprox. 1 p.]. Disponible en: http://www.ccforum.com/content/supplementary/cc11895-s2.pdf

  7. Lee Char SJ, Evans LR, Malvar GL, White DB. A randomized trial of two methods to disclose prognosis to surrogate decision makers in intensive care units. Am J Respir Crit Care Med [Internet]. 2010 [citado 12 Jun 2014];182(7):905-9. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/20538959

  8. Vincent JL, Nelson DR, Williams MD. Is worsening multiple organ failure the cause of death in patients with severe sepsis? Crit Care Med [Internet]. 2011 [citado 12 Jun 2014]; 39(5):1050-5. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21317650

  9. Talwani R, Gilliam BL, Howell C. Infectious diseases and the liver. Clin Liver Dis [Internet]. 2011 [citado 12 Jun 2014];15(1):111-30. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21111996

  10. 10.Zhu JH, Lei XG. Lipopolysaccharide-induced hepatic oxidative injury is not potentiated by knockout of GPX1 and SOD1 in mice. Biochem Biophys Res Commun [Internet]. 2011 [citado 12 Jun 2014]; 404(1):559-63. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21145306

  11. 11.Ferreira Sernache de Freitas ER. Perfil y gravedad de los pacientes de las unidades de terapia intensiva: aplicación prospectiva del puntaje APACHE II. Rev Latino-Am Enfermagem [Internet]. 2010 [citado 12 Jun 2014];18(3):[aprox. 7 p]. Disponible en: http://www.scielo.br/pdf/rlae/v18n3/es_04.pdf

  12. 12.Hernández-Palazón J, Fuentes-García D, Burguillos-López LS, Doménech-Asensi P, Sansano-Sánchez TV, Acosta-Villegas F. Análisis de la insuficiencia de órganos y mortalidad en la sepsis por peritonitis secundaria. Med Intensiva [Internet]. 2013 [citado 12 Jun 2014];37(7):461-467. Disponible en: http://www.sciencedirect.com/science/article/pii/S0210569112002501

  13. 13.Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med [Internet]. 2013 [citado 12 Jun 2014];41(2):580-637. Disponible en: http://www.sccm.org/Documents/SSC-Guidelines.pdf

  14. 14.Samraj RS, Zingarelli B, Wong HR. Role of biomarkers in sepsis care. Shock [Internet]. 2013 [citado 25 Feb 2014];40(5):358-65. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/24088989

  15. 15.Suberviola B, Castellanos-Ortega A, Ruiz Ruiz A, Lopez H M, Santibañez M. Hospital mortality prognostication in sepsis using the new biomarkers suPAR and proADM in a single determination on ICU admission. Intensive Care Med [Internet]. 2013 [citado 25 Feb 2014];39(11):1945-52. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23949703

  16. 16.León C, Ruiz-Santana S, Saavedra P, Castro C, Ubeda A, Loza A, et al. Value of β-D-glucan and Candida albicans germ tube antibody for discriminating between Candida colonization and invasive candidiasis in patients with severe abdominal conditions. Intensive Care Med [Internet]. 2012 [citado 25 Feb 2014]; 38(8):1315-25. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/22752333

  17. 17.Fariñas Vilela AH, Dáger Haber A. Sepsis y trastornos relacionados. MEDISAN [Internet]. 2012 [citado 25 Feb 2014];6(6):[aprox. 12 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192012000600014

  18. 18.Desai S, Lakhani JD. Utility of SOFA and APACHE II score in sepsis in rural set up MICU. J Assoc Physicians India [Internet]. 2013 [citado 25 Feb 2014];61(9):608-11. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/24772695

  19. 19.Esper AM, Moss M, Lewis CA, Nisbet R, Mannino DM, Martin GS. The role of infection and comorbidity: factors that influence disparities in sepsis. Crit Care Med [Internet]. 2006 [citado 25 Feb 2014]; 34(10):2576-2582. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/16915108

  20. Mayr FB, Yende S, Linde-Zwirble WT, Peck-Palmer OM, Barnato AE, Weissfeld LA, et al. Infection rate and acute organ dysfunction risk as explanations for racial in severe sepsis. JAMA [Internet]. 2010 [citado 25 Feb 2014];303(24):2495-2503. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/20571016




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