Abstract:
OBJECTIVE:The Sequential Organ Failure Assessment (SOFA) score was developed to quantify the severity of patients' illness, based on the degree of organ dysfunction. This study aimed to evaluate the accuracy and the reliability of SOFA scoring. DESIGN:Prospective study. SETTING:Adult intensive care unit (ICU) in a tertiary academic center. SUBJECTS:Thirty randomly selected patient cases and 20 ICU physicians. MEASUREMENTS AND MAIN RESULTS:Each physician scored 15 patient cases. The intraclass correlation coefficient was .889 for the total SOFA score. The weighted kappa values were moderate (0.552) for the central nervous system, good (0.634) for the respiratory system, and almost perfect (>0.8) for the other organ systems. To assess accuracy, the physicians' scores were compared with a gold standard based on consensus of two experts. The total SOFA score was correct in 53% (n = 158) of the cases. The mean of the absolute deviations of the recorded total SOFA scores from the gold standard total SOFA scores was 0.82. Common causes of errors were inattention, calculation errors, and misinterpretation of scoring rules. CONCLUSIONS:The results of this study indicate that the reliability and the accuracy of SOFA scoring among physicians are good. We advise implementation of additional measures to further improve reliability and accuracy of SOFA scoring.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Arts DG,de Keizer NF,Vroom MB,de Jonge Edoi
10.1097/01.ccm.0000178178.02574.absubject
Has Abstractpub_date
2005-09-01 00:00:00pages
1988-93issue
9eissn
0090-3493issn
1530-0293pii
00003246-200509000-00014journal_volume
33pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVES:Cardiovascular dysfunction occurs in the majority of asphyxiated neonates and has been suggested to be a major cause of neonatal morbidity and mortality. We previously demonstrated that cyclosporine A treatment during resuscitation can significantly improve cardiovascular performance in asphyxiated newborn p...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182746704
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:To measure pulmonary capillary pressure and pulmonary artery occlusion pressures both during control conditions and during acute lung injury and to evaluate the effects of inotropic therapy and volume loading on these measurements after lung injury. DESIGN:Prospective, randomized, controlled laboratory tria...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200202000-00023
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVES:We aimed to implement our Smart Use of Antibiotics Program to ensure the proper use of antimicrobials, improve patient care and outcomes, and reduce the risks of adverse effects and antimicrobial resistance. DESIGN:We compared the time periods before (baseline) and after (intervention) the implementation of...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003463
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVES:To determine nuclear factor kappa B (NF-kappa B) activation in mononuclear and neutrophils from critically ill patients and to compare NF-kappa B activation with circulating concentrations of interleukin (IL)-6, IL-8, and soluble intercellular adhesion molecule (sICAM)-1. DESIGN:Observational study. SETTIN...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200004000-00022
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:Transfusion of red blood cells has been linked to disappointing clinical outcomes in the critically ill, but specific mechanisms of organ dysfunction after transfusion remain poorly understood. We tested the hypothesis that red blood cell storage impairs the ability of red blood cells to release adenosine-5'-...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318225754f
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between nitric oxide production, endotoxemia, and hemodynamic alterations in human septic shock. DESIGN:Prospective study. SETTING:A 32-bed intensive care unit in a university referral hospital. PATIENTS:Two groups of septic patients with shock (n = 13) or without shock (n =...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199502000-00009
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVE:In rodent models, enhanced formation of nitric oxide and formation of peroxynitrite have been implicated in the pathogenesis of various forms of shock. Here we examined the effect of mercaptoethylguanidine (MEG), an inducible nitric oxide synthase inhibitor and peroxynitrite scavenger, in a severe hemorrhagic...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199907000-00027
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Venous thromboembolic disease is among the most common causes of morbidity and mortality during pregnancy. The clinical evaluation alone is insufficient for the diagnosis of venous thromboembolic disease, and the normal pregnant state makes this evaluation even more challenging. DIAGNOSIS:Objective testing ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.ccm.0000183157.15533.4c
更新日期:2005-10-01 00:00:00
abstract::Arterial and transcutaneous O2 (PtcO2) and CO2 (PtcCO2) tensions, arterial O2 saturations (SaO2) and P50 values were measured in 47 patients before extubation. In order to unmask ventilation to perfusion (VA/Q) inequality, all variables were obtained without CPAP and with FIO2 of 0.40 as well as with CPAP of 5 cm H2O ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198309000-00007
更新日期:1983-09-01 00:00:00
abstract:OBJECTIVE:This report will describe the preparations for and the provision of care of two patients with Ebola virus disease in the biocontainment unit at the University of Nebraska Medical Center. DATA SOURCES:Patient medical records. STUDY SELECTION:Not applicable. DATA EXTRACTION:Not applicable. DATA SYNTHESIS:No...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000000935
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:To determine the accuracy and reproducibility of four thermodilution indicators (5-mL room temperature, 10-mL room temperature, 5-mL iced, and 10-mL iced injectates) at clinically relevant flow rates. DESIGN:Quasi-experimental study. SETTING:Animal research laboratory of a health sciences university. SUBJE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199304000-00021
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVE:Isoflurane, a volatile anesthetic agent, has been recognized for its potential neuroprotective properties and has antiapoptotic effects. We examined whether isoflurane posttreatment is protective against early brain injury after subarachnoid hemorrhage and determined whether this effect needs sphingosine-rela...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3182474bc1
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:Brain death induces a massive inflammatory response. However, the influence of this inflammatory response on organ procurement, transplantation, and recipient outcome is unknown. We describe the inflammatory response characteristics in brain-dead organ donors and examine associations with organ transplantati...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318174d89f
更新日期:2008-06-01 00:00:00
abstract::Recent advances in prenatal and neonatal care have increased the number of live births and extended the life expectancy of critically ill premature infants. These infants represent a formidable therapeutic challenge in that multisystem involvement and previously uncommon conditions, such as intravascular coagulation, ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197701000-00007
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:To compare the outcomes and the short- and long-term complications of percutaneous translaryngeal tracheostomy (TLT) and surgical tracheostomy (ST). DESIGN:Prospective, randomized clinical trial with 1-yr double-blind follow-up. SETTING:A general intensive care unit of a university hospital. PATIENTS:A tot...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.ccm.0000163401.77581.86
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVES:Acute renal failure is a complication in critically ill patients that has been associated with an excess risk of hospital mortality. Whether this reflects the severity of the disease or whether acute renal failure is an independent risk factor is unknown. The aim of this study was to analyze severity of illn...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/00003246-200209000-00016
更新日期:2002-09-01 00:00:00
abstract::The conjunctival oxygen monitor reflects oxygen tension of the internal carotid artery without introducing the heating artifact characteristic of transcutaneous monitors. It is now being used in the ICU and the operating room to measure accurately and continuously Po2 and temperature of conjunctival tissue. We examine...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198508000-00016
更新日期:1985-08-01 00:00:00
abstract:OBJECTIVES:Lung contusion is a major risk factor for the development of acute respiratory distress syndrome. We set to determine the role of toll-like receptor 3 and the binding of double-stranded RNA in the pathogenesis of sterile injury following lung contusion. DESIGN:Toll-like receptor 3 expression was analyzed in...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001879
更新日期:2016-11-01 00:00:00
abstract::There is an increasing evidence that survivors of critical illness suffer from impaired health-related quality of life. There are relatively few studies that have evaluated the effect of interventions in clinical trials to improve these long-term outcomes. Studies to improve long-term outcomes after critical illness f...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181922bb7
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of the selective alpha 1-adrenergic receptor agonist phenylephrine in the hemodynamic support of patients with septic shock. DESIGN:Retrospective analysis of clinical use of phenylephrine. SETTING:Surgical ICU in a university hospital. PATIENTS:Thirteen patients with septic shock (diagn...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199111000-00016
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVE:Opioids are frequently used during mechanical ventilation for severe viral infection in infancy. Opioid receptors have immunomodulatory properties, but nothing is known about their antiviral effects. We therefore aimed to investigate the role of opioid receptors in virus-induced airway inflammation. PATIENTS...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31826767a8
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To define the relative needs of the staffs of rural, community hospitals for training in advanced cardiac life support (ACLS), identify weaknesses, and modify a standard ACLS course to meet these needs. DESIGN:Prospective assessment of knowledge and skills relating to the practice of ACLS. SETTING:Rural, co...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199405000-00006
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE:Because anemia of inflammation is common in ICU patients and hepcidin is the key regulator of iron homeostasis, we examined time-dependent changes in hepcidin, erythropoietin, iron, and inflammatory markers in surgical ICU patients with anemia. DESIGN:Prospective single-center clinical noninterventional stud...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003089
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:An increasing number of ICU patients survive and develop mental, cognitive, or physical impairments. Various interventions support recovery from this postintensive care syndrome. Physicians in charge of post-ICU patients need to know which interventions are effective. DATA SOURCES:Systematic literature searc...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0000000000000148
更新日期:2014-05-01 00:00:00
abstract::The venous-arterial PCO2 gradient may increase in certain low-flow states, such as CPR and canine endotoxemia. To determine whether venous hypercarbia also occurs in hemorrhagic shock, we studied 12 anesthetized, mechanically ventilated dogs. We performed laparotomies on the animals, inserting catheters into their ren...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198705000-00013
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVES:To evaluate the epidemiology of hyperammonemia unrelated to liver failure in the critical care setting. DESIGN:Retrospective case series. SETTING:Critically ill patients admitted to ICUs at Mayo Clinic, Rochester, MN (medical ICU, two mixed medical-surgical ICUs, coronary care unit, or the cardiosurgical I...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003278
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:To assess the mortality rate and complications in a population of surgical patients with severe adult respiratory distress syndrome (ARDS) treated with positive end-expiratory pressure (PEEP) of > 15 cm H2O in an attempt to reduce intrapulmonary shunt to approximately 0.20 and reduce FIO2 to < 0.50. DESIGN:R...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199509000-00008
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:To determine whether mechanical ventilation using high tidal volume is associated with nonpulmonary organ dysfunction that can be attenuated by dexamethasone. DESIGN:Prospective randomized animal intervention study. SETTING:Animal care facility in a university hospital. SUBJECTS:Sedated and tracheostomized...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000205663.92384.E7
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To compare the effects of cardiac surgery with and without extracorporeal circulation on the mechanics of the respiratory system, lung, and chest wall. We also determined the time course of those effects. DESIGN:Prospective, controlled study. SETTING:An eight-bed, cardiac-surgical intensive care unit at a u...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-200211000-00005
更新日期:2002-11-01 00:00:00
abstract::We compared the degree of complement activation in 15 patients receiving massive blood transfusions and 21 patients with the septic syndrome and examined its association with other risk factors for adult respiratory distress syndrome (ARDS). Patients with massive transfusion (n = 8) as their only risk factor for ARDS ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198612000-00001
更新日期:1986-12-01 00:00:00