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2 "Yeseul Oh"
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Pulmonary
Development of a prognostic scoring system in patients with pneumonia requiring ventilator care for more than 4 days: a single-center observational study
Yeseul Oh, Yewon Kang, Kwangha Lee
Acute Crit Care. 2021;36(1):46-53.   Published online February 17, 2021
DOI: https://doi.org/10.4266/acc.2020.00787
  • 5,511 View
  • 117 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
The aim of the present study was to develop a prognostic model using demographic characteristics, comorbidities, and clinical variables measured on day 4 of mechanical ventilation (MV) for patients with prolonged acute mechanical ventilation (PAMV; MV for >96 hours).
Methods
Data from 437 patients (70.9% male; median age, 68 years) were obtained over a period of 9 years. All patients were diagnosed with pneumonia. Binary logistic regression identified factors predicting mortality at 90 days after the start of MV. A PAMV prognosis score was calculating ß-coefficient values and assigning points to variables.
Results
The overall 90-day mortality rate was 47.1%. Five factors (age ≥65 years, body mass index <18.5 kg/m2, hemato-oncologic diseases as comorbidities, requirement for vasopressors on day 4 of MV and requirement for neuromuscular blocking agents on day 4 of MV) were identified as prognostic indicators. Each factor was valued as +1 point, and used to develop a PAMV prognosis score. This score showed acceptable discrimination (area under the receiver operating characteristic curve of 0.695 for mortality, 95% confidence interval 0.650–0.738, p<0.001), and calibration (Hosmer–Lemeshow chi-square=6.331, with df 7 and p=0.502). The cutoff value for predicting mortality based on the maximum Youden index was ≤2 (sensitivity, 87.5%; specificity, 41.3%). For patients with PAMV scores ≤1, 2, 3 and ≥4, the 90-day mortality rates were 29.2%, 45.7%, 67.9%, and 90.9%, respectively (P<0.001).
Conclusions
Our study developed a PAMV prognosis score for predicting 90-day mortality. Further research is needed to validate the utility of this score.

Citations

Citations to this article as recorded by  
  • Ability of the modified NUTRIC score to predict mortality in patients requiring short-term versus prolonged acute mechanical ventilation: a retrospective cohort study
    Wanho Yoo, Hyojin Jang, Hayoung Seong, Saerom Kim, Soo Han Kim, Eun-Jung Jo, Jung Seop Eom, Kwangha Lee
    Therapeutic Advances in Respiratory Disease.2024;[Epub]     CrossRef
  • Association between mechanical power and intensive care unit mortality in Korean patients under pressure-controlled ventilation
    Jae Kyeom Sim, Sang-Min Lee, Hyung Koo Kang, Kyung Chan Kim, Young Sam Kim, Yun Seong Kim, Won-Yeon Lee, Sunghoon Park, So Young Park, Ju-Hee Park, Yun Su Sim, Kwangha Lee, Yeon Joo Lee, Jin Hwa Lee, Heung Bum Lee, Chae-Man Lim, Won-Il Choi, Ji Young Hong
    Acute and Critical Care.2024; 39(1): 91.     CrossRef
Pulmonary
Sequential Organ Failure Assessment score as a predictor of mortality in ventilated patients with multidrug-resistant bacteremia
Yeseul Oh, Jiyeon Roh, Jaemin Lee, Hyun Sung Chung, Kwangha Lee, Min Ki Lee
Acute Crit Care. 2020;35(3):169-178.   Published online August 31, 2020
DOI: https://doi.org/10.4266/acc.2020.00143
  • 4,421 View
  • 111 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
The occurrence of multidrug-resistant (MDR) bacteremia in ventilated patients may be associated with a high mortality rate. We evaluated whether Sequential Organ Failure Assessment (SOFA) score on the day of bacteremia could predict 90-day mortality in these patients.
Methods
Data were obtained retrospectively from 202 patients (male, 60.4%; median age, 64 years) hospitalized at a single university-affiliated tertiary care hospital. All adult patients who had were ventilated and had one of the following six MDR bacteremias between March 2011 and February 2018 were enrolled: methicillin-resistant Staphylococcus aureus, extended-spectrum β-lactamase-producing Gram-negative bacteria (Escherichia coli and Klebsiella pneumonia), carbapenem-resistant Gram-negative rods (Acinetobacter baumannii and Pseudomonas aeruginosa), or vancomycin-resistant Enterococcus faecium.
Results
The overall 90-day mortality rate after the day of bacteremia was 59.9%. The areas under the receiver operating characteristic curves for the SOFA and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were 0.732 (95% confidence interval [CI], 0.666 to 0.792; P<0.001) and 0.662 (95% CI, 0.593 to 0.727; P<0.001), respectively, with no difference between the two (P=0.059). Also, the cutoff value of the SOFA score was 9 (based on Youden’s index). Multivariate Cox regression analysis showed that this cut-off value was significantly associated with higher mortality rate (hazard ratio, 2.886; 95% CI, 1.946 to 4.221; P<0.001).
Conclusions
SOFA score measured on the day of bacteremia may be a useful prognostic indicator of 90-day mortality in ventilated patients with MDR bacteremia.

Citations

Citations to this article as recorded by  
  • Serial evaluation of the serum lactate level with the SOFA score to predict mortality in patients with sepsis
    Heemoon Park, Jinwoo Lee, Dong Kyu Oh, Mi Hyeon Park, Chae-Man Lim, Sang-Min Lee, Hong Yeul Lee
    Scientific Reports.2023;[Epub]     CrossRef
  • The value of admission Troponin I to predict outcomes in suspected infections in elderly patients admitted in Internal Medicine: results from the SOFA-T collaboration, a multi-center study
    N. Tarquinio, G. Viticchi, V. Zaccone, M. Martino, A. Fioranelli, P. Morciano, G. Moroncini, C. Di Pentima, A. Martini, C. Nitti, A. Salvi, M. Burattini, L. Falsetti
    Internal and Emergency Medicine.2021; 16(4): 981.     CrossRef

ACC : Acute and Critical Care