Abstract:
BACKGROUND:The number of very elderly ICU patients (abbreviated to VOPs; ≥80 years) with sepsis increases. Sepsis was redefined in 2016 (sepsis 3.0) using the quick SOFA (qSOFA) score. Since then, multiple studies have validated qSOFA for prognostication in different patient categories, but the prognostic value in VOPs with sepsis is still unknown. METHODS:Retrospective cohort study including patients admitted to Dutch ICUs with sepsis, in the period 2012 to 2016, evaluating the outcome and the performance of qSOFA, an extended qSOFA model, SOFA, SAPS II, and APACHE IV for hospital mortality. RESULTS:5969 patients were included, of which 935 VOPs. Crude hospital mortality rates were 19%, 28%, and 39% for patients aged 18-65, 65-80, and ≥80 years respectively. Discriminative performance of qSOFA for in-hospital mortality in VOPs was poor (AUC 0.596) and lower than that of SOFA, APACHE IV, and SAPS II (0.704, 0.722, and 0.780 respectively). A qSOFA model extended with several other characteristics (AUC 0.643) was non-inferior to the full SOFA, but still inferior to APACHE IV and SAPS II, for all age groups. The Hosmer-Lemeshow goodness-of-fit test showed non-significant p-values for all models. Accuracy for both qSOFA and the extended qSOFA was lower compared to APACHE IV and SAPS II (Brier scores 0.227, 0.223, 0.184, and 0.183 respectively). CONCLUSION:The qSOFA showed worse discriminative performance to predict mortality than SOFA, APACHE IV, and SAPS II in both VOPs and younger patients admitted with sepsis.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Haas LEM,Termorshuizen F,de Lange DW,van Dijk D,de Keizer NFdoi
10.1111/aas.13536subject
Has Abstractpub_date
2020-04-01 00:00:00pages
508-516issue
4eissn
0001-5172issn
1399-6576journal_volume
64pub_type
杂志文章abstract:BACKGROUND:Many studies demonstrate an association between brain damage and the extracellular release of catecholamines and amino acids during cerebral ischemia. While the clinical value of hypothermia during periods of compromised cerebral blood flow and oxygen delivery is well established, the role of anesthetic agen...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.1999.431004.x
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:We designed this study to compare the postoperative analgesic effects of intrathecal morphine and nalbuphine, the endpoints being onset and offset of action. METHODS:Geriatric patients scheduled for elective total hip replacement under continuous spinal anaesthesia were randomized to two double-blinded grou...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1034/j.1399-6576.2000.440808.x
更新日期:2000-09-01 00:00:00
abstract::Forty patients who underwent elective cholecystectomy were examined preoperatively and during the first postoperative week by physical examination, measurement of FVC and FEV1, arterial pH and blood gas analyses, and chest x-ray. Postoperative pulmonary complications (p.p.c.) were detected in 30 (75%) of the patients....
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1977.tb01211.x
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:Excitotoxic neuronal injury from ischemia may be reduced by local anesthetics. We investigated the neuroprotective effects of intrathecally administered bupivacaine and hypothermia in a rat model of transient spinal cord ischemia. METHODS:PE-10 intrathecal catheter-implanted male Sprague-Dawley rats were ra...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2006.01163.x
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Anaesthesia in patients with ischaemic heart disease may cause adverse haemodynamic reactions. This investigation compares the cardiovascular effects of equipotent concentrations of desflurane and isoflurane in 30 patients (ASA III) with coronary artery disease before surgical stimulation. METHODS:After sta...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1996.tb05571.x
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Goal-directed therapy has been proposed to improve outcome in high-risk surgery patients. The aim of this study was to investigate whether individualised goal-directed therapy targeting stroke volume and oxygen delivery could reduce the number of patients with post-operative complications and shorten hospita...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-6576.2012.02755.x
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Spinal anesthesia with different doses of intrathecal morphine has been shown to relieve post-operative pain. We studied in a prospective randomized, double-blind fashion the effects of morphine 0, 100, 200, or 300 μg added to intrathecal bupivacaine on first post-operative 24 h patient-controlled analgesia ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-6576.2011.02574.x
更新日期:2012-01-01 00:00:00
abstract::A schizophrenic patient on long-time neuroleptic medication was admitted with ileus. Secondarily, a high fever, rigidity, mental confusion, tachycardia and hypotension developed. After bromocriptine was given, the temperature dropped by 2 degrees C and the patient improved markedly. A diagnosis of neuroleptic malignan...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.2003.00193.x
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:We prospectively evaluated direct analgesia-related costs of continuous sciatic nerve block using either a stimulating or conventional catheter after hallux valgus repair. METHODS:The perineural catheter was inserted through a stimulating introducer either blindly (group Conventional, n= 38) or while stimul...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2006.01101.x
更新日期:2006-11-01 00:00:00
abstract::The effects of epinephrine as an adjuvant to local anesthetics were studied in the rat infraorbital nerve block (IONB) model, using solutions of 0.5% prilocaine, 0.5% mepivacaine, 0.125% bupivacaine or 0.125% ropivacaine in 50 mmol/l tris-hydroxymethylaminomethane (THAM) tested both without and with epinephrine (EPI) ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1992.tb03486.x
更新日期:1992-07-01 00:00:00
abstract::An important element of how adverse events are handled is effective communication between health care providers and patients and their families. This review addresses the main questions: What do patients expect in the aftermath of an adverse event? What is known about the practice of open disclosure? How can organizat...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,评审
doi:10.1111/j.1399-6576.2005.00746.x
更新日期:2005-07-01 00:00:00
abstract::We report on a 65-year-old female with an aneurysmal subarachnoid hemorrhage (SAH) that was followed clinically, radiologically and electrophysiologically before and after converting from intracranial pressure (ICP)-guided to ICP wave-guided intensive care management. Intracranial pressure-guided management is aimed a...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2007.01269.x
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Patients' difficulties following critical illness and the willingness of intensive care units (ICU) to take an expanded responsibility during the recovery period have led to the development of different follow-up programs. The aim of this study was to explore and describe patients' participation in and evalu...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2011.02474.x
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Traumatic rib fractures are a common condition associated with considerable morbidity and mortality. Observational studies have suggested improved outcome in patients receiving continuous epidural analgesia (CEA). The aim of the present systematic review of randomised controlled trials (RCTs) was to assess t...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,评审
doi:10.1111/aas.12475
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Myoclonic movements are a common problem during the induction of general anesthesia with etomidate. We investigated the influence of pretreatment with the opioid sufentanil on the incidence of etomidate-induced myoclonus. METHODS:Forty female patients (ASA physical status I-III) were randomly assigned to re...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1034/j.1399-6576.2003.00081.x
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:The aim of the study was to investigate the correlation between EEG indicators and clinical scores based on the RLS85 (Reaction Level Scale 85) in comatose patients. The results of a simple visual assessment of the EEG, using an arbitrary scale with typical EEG patterns, were compared with those obtained by ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1996.tb04540.x
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:The relative potency of the steroid anaesthetic agent eltanolone has been compared with respect to induction of anaesthesia in ASA I and II young (18-40 years) and elderly (> 65 years) patients. METHOD:113 temazepam premedicated patients (60 elderly) were evaluated in an open randomised study. They were all...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1997.tb04862.x
更新日期:1997-10-01 00:00:00
abstract::Female geriatric patients (mean age 80.9 years; n = 169) undergoing surgery for hip fracture were given epidural, neurolept analgesia, ketamine, enflurane or halothane anesthesia. The rate of survival in the different groups was studied up to 4 years after the operation and compared with the expected survival of norma...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1982.tb01825.x
更新日期:1982-12-01 00:00:00
abstract::Standardized behavioural observations were used to establish the influence of the type of anaesthesia on the mental function and the subjective physical well-being in 60 patients, all men, following urological surgery. The patients were randomized to two groups, receiving spinal or general anaesthesia. For evaluation ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1992.tb03531.x
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:Cytokines and their inhibitors are thought to be involved in many of the pathophysiological changes associated with trauma and infection. The magnitude of the trauma and the degree of tissue damage have an impact on the trauma response. The purpose of the study was to examine cytokine and hormonal responses ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章
doi:10.1034/j.1399-6576.1999.430205.x
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:There is some evidence that patients' outcomes improve if they are involved in shared decision making (SDM). A chronic pain clinic or premedication visit could be adequate settings for the implementation of SDM. So far, the patients' preference for involvement in decision making and their desire for informat...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2006.01097.x
更新日期:2006-09-01 00:00:00
abstract::Segmental epidural analgesia (T10-T12) was performed in 418 parturients, using a 4-6 ml dose of 0.5% bupivacaine, with or without adrenaline. Seventy per cent of parturients were primiparas and 30% had histories, or signs, of possible uteroplacental insufficiency. Our aim was to relieve pain during the long passive op...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1977.tb01207.x
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:To compare the incidence of postural post-dural puncture headache (PPDPH) after spinal anaesthesia using two different 0.40 mm O.D. (27 g) spinal needles: pencil-point needle and Quincke needle. In addition, a meta-analysis of studies comparing small bore spinal needles with regard to development of PPDPH wa...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,meta分析,随机对照试验
doi:10.1034/j.1399-6576.2000.440603.x
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Venous gas embolism is a rare but severe event in critically ill patients and the diagnosis should be obtained as soon as possible. Ultrasonography is a sensitive, non-invasive, and bedside means of detection. METHOD:We prospectively estimated the performance of two-dimensional (2D) echocardiography and pul...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.1999.430314.x
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Onset time of specific non-depolarizing muscle relaxants (NDMR), as reported in the literature, varies widely. To test the suggestion of a consensus panel (Copenhagen Consensus Conference 1996) that onset time in muscle relaxant studies depends on stimulation frequency, even in the low frequency range, we ex...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.2000.440207.x
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Pain is a sensory and emotional experience that is influenced by physiologic, sensory, affective, cognitive, socio-cultural, and behavioral factors. Consistent with the perspective to improve the postoperative pain control, the present study has the purpose of assessing the effect of presurgical clinical fac...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.2002.461015.x
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:Femoral nerve blocks have been the gold standard approach for post-operative analgesia following total knee arthroplasty; however, the adductor canal block has recently gained popularity due to less block-induced motor weakness. The primary aim of this time-series analysis was to identify whether regional an...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12845
更新日期:2017-02-01 00:00:00
abstract::Application of self-administered postoperative prophylactic positive expiratory pressure (S-PEP) treatment in addition to conventional physiotherapy was investigated in 75 patients undergoing thoracotomy. Twenty-nine patients used a face-mask set supplied with an expiratory resistance (S-PEP group) and 27 patients use...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1986.tb02435.x
更新日期:1986-07-01 00:00:00
abstract::4-aminopyridine has earlier been shown to antagonize neuromuscular block and to release transmitters in CNS. In a study in man the drug was given intravenously at the end of anaesthesia in order to counteract muscle relaxation and possibly also anaesthesia. The effects were followed by clinical observations, intraarte...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1983.tb01911.x
更新日期:1983-02-01 00:00:00
abstract:BACKGROUND:Full-scale simulators have been developed in anaesthesia. We aimed at assessing Danish anaesthesia residents' knowledge and management of a standardized difficult airway situation in an advanced airway simulator. The reliability of the assessment was also determined. METHODS:Thirty-six residents answered a ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.0001-5172.2004.00422.x
更新日期:2004-09-01 00:00:00