Dataset Information

Clinical profile and outcomes of acute cardiorenal syndrome type-5 in sepsis: An eight-year cohort study.

ABSTRACT:

Background

To evaluate the clinical features and outcomes of acute cardiorenal syndrome type-5 in patients with severe sepsis and septic shock.

Methods

Historical cohort study of all adult patients with severe sepsis and septic shock admitted to the intensive care units (ICU) at Mayo Clinic Rochester from January 1, 2007 through December 31, 2014. Patients with prior renal or cardiac dysfunction were excluded. Patients were divided into groups with and without cardiorenal syndrome type-5. Acute Kidney Injury (AKI) was defined by both serum creatinine and urine output criteria of the AKI Network and the cardiac injury was determined by troponin-T levels. Outcomes included in-hospital mortality, ICU and hospital length of stay, and one-year survival.

Results

Of 602 patients meeting the study inclusion criteria, 430 (71.4%) met criteria for acute cardiorenal syndrome type-5. Patients with cardiorenal syndrome type-5 had higher severity of illness, greater vasopressor and mechanical ventilation use. Cardiorenal syndrome type-5 was associated higher unadjusted in-hospital mortality, ICU and hospital lengths of stay, and lower one-year survival. When adjusted for age, gender, severity of illness and mechanical ventilation, cardiorenal syndrome type-5 was independently associated with 1.7-times greater odds of in-hospital mortality (p = .03), but did not predict one-year survival (p = .06) compared to patients without cardiorenal syndrome.

Conclusions

In sepsis, acute cardiorenal syndrome type-5 is associated with worse in-hospital mortality compared to patients without cardiorenal syndrome.

SUBMITTER: Vallabhajosyula S

PROVIDER: S-EPMC5760054 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Clinical profile and outcomes of acute cardiorenal syndrome type-5 in sepsis: An eight-year cohort study.

Vallabhajosyula Saraschandra S Sakhuja Ankit A Geske Jeffrey B JB Kumar Mukesh M Kashyap Rahul R Kashani Kianoush K Jentzer Jacob C JC

PloS one 20180109 1

<h4>Background</h4>To evaluate the clinical features and outcomes of acute cardiorenal syndrome type-5 in patients with severe sepsis and septic shock.<h4>Methods</h4>Historical cohort study of all adult patients with severe sepsis and septic shock admitted to the intensive care units (ICU) at Mayo Clinic Rochester from January 1, 2007 through December 31, 2014. Patients with prior renal or cardiac dysfunction were excluded. Patients were divided into groups with and without cardiorenal syndrome ...[more]

PMID: 29315332

Similar Datasets

Project description:ObjectiveEarly prediction of long-term outcomes in patients with sepsis-induced cardiorenal syndrome (CRS) remains a great challenge in clinical practice. Herein, we aimed to construct a nomogram and machine learning model for predicting the 1-year mortality risk in patients with sepsis-induced CRS.MethodsThis retrospective study enrolled 340 patients diagnosed with sepsis-induced CRS in Shanghai Tongji Hospital between January 2015 and May 2019, as a discovery cohort. Two predictive models, the nomogram and machine learning model, were used to predict 1-year mortality. The prognostic variables used to develop the nomogram were identified based on a forward stepwise binary logistic regression, and the predictive ability of the nomogram was evaluated by the areas under the receiver operating characteristic curve (AUC) and the calibration curve. Meanwhile, machine learning (ML) techniques, such as support vector machine, random forest (RF), and gradient boosted decision tree, were assessed mainly by accuracy and AUC. Feature ranking analysis was performed using the ML algorithm. Both nomogram and ML models were externally validated by an independent cohort of 103 patients diagnosed with sepsis-induced CRS between June 2019 and December 2020.ResultsAge, sequential sepsis-related organ failure score (SOFA), serum myoglobin (MYO), vasopressor use, and mechanical ventilation were identified as independent risk factors for 1-year mortality in the nomogram predictive model. In the discovery cohort, the nomogram yielded higher AUC for predicting mortality than did the SOFA score (0.855 [95% CI: 0.815-0.895] vs. 0.756 [95% CI: 0.705-0.808]). For ML, the model developed by RF showed the highest accuracy (0.765) and AUC (0.854). In feature ranking analysis, factors such as age, MYO, SOFA score, vasopressor use, and baseline serum creatinine were identified as important features affecting 1-year prognosis. Moreover, the nomogram and RF model both performed well in external validation, with an AUC of 0.877 and 0.863, respectively.ConclusionOur nomogram and ML models showed that age, SOFA score, serum MYO levels, and the use of vasopressors during hospitalization were the main factors influencing the risk of long-term mortality. Our models may serve as useful tools for assessing long-term prognosis in patients with sepsis-induced CRS.

Dataset Information

Clinical profile and outcomes of acute cardiorenal syndrome type-5 in sepsis: An eight-year cohort study.

Background

Methods

Results

Conclusions

Publications

Clinical profile and outcomes of acute cardiorenal syndrome type-5 in sepsis: An eight-year cohort study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets