Early complications of high-dose methylprednisolone in acute spinal cord injury patients

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• 作者：Borja Suberviola ; Alej ; ro Gonzá ; lez-Castro ; Javier Llorca ; Fern ; o Ortiz-Meló ; n ; Eduardo Miñ ; ambres
• 关键词：Spinal cord injury ; Methylprednisolone ; Neurological function ; Outcome
• 刊名：Injury
• 出版年：2008
• 出版时间：July 2008
• 年：2008
• 卷：39
• 期：7
• 页码：748-752
• 全文大小：89 K

文摘

This study is a subanalysis of the database from the observational Sepsis Occurrence in Acutely Ill Patients study conducted in 198 ICUs in 24 European countries between May 1 and May 15, 2002. Potential predictors of post-ICU mortality were considered at 3 levels: admission status, procedures and therapy during the ICU stay, and status at ICU discharge.

Results

Of the 3147 patients included in the Sepsis Occurrence in Acutely Ill Patients study, 1729 (54.9 % ) were discharged to the general floor (study group) and 125 of these died (overall post-ICU hospital mortality rate, 4 % ); 26 (20.8 % ) died already the first day on the floor. Nonsurvivors were older, had higher incidence of hematologic cancer and cirrhosis, and greater Simplified Acute Physiology Score II and Sequential Organ Failure Assessment score on ICU admission; they were also more likely to have been admitted for medical reasons than survivors. In a multivariate forward stepwise logistic regression analysis, age, hematologic cancer, cirrhosis, simplified acute physiology score II on admission, medical admission, sepsis at any time during ICU stay, and organ dysfunction at ICU discharge were all independently associated with a greater risk of post-ICU death.

Conclusions

This large international study identified not only age, medical admission, and preexisting comorbidities on ICU admission but also sepsis and organ system failure as important independent risk factors for in-hospital post-ICU death.