Shock. 2022 Nov 17. doi: 10.1097/SHK.0000000000002035. Online ahead of print.
ABSTRACT
OBJECTIVE: To investigate and compare the clinical features and prognosis of chronic critical illness (CCI)/ persistent inflammation immunosuppression and catabolism (PICS).
METHODS: This is a prospective observational clinical study. During this study period, we collect ICU patients’ data from Suzhou Municipal Hospital and Suzhou Ninth People’s Hospital. All patients older than 18 years of age were included and according to the corresponding exclusion and diagnostic criteria, they were divided into four groups: PICS group, CCI group, CCI and PICS group (CCI + PICS), nor CCI and nor PICS group (NCCI+NPICS), collected and recorded age, sex, hospital time, hospital diagnosis, acute physiological and chronic health status score II (APACHEII), sequential organ failure detection score(SOFA), c-reactive protein (CRP), absolute value lymphocyte count (L), serum albumin (Alb), white cells count (WBC), absolute value neutrophils count (N), secondary infection and 28-day case fatality rate separately.
RESULTS: A total of 687 patients were admitted to the ICU during the study period. The hospitalization time less than 14 days were excluded, and 168 patients were eventually included. There are 17 in the PICS group, 71 in the CCI group, 50 in the CCI + PICS group, and 30 in the NCCI+NPICS group. Baseline characteristics showed statistically significant differences in SOFA, length of hospital stay, 28-day mortality among four groups. Baseline main indicator, and multiple comparisons showed that the CCI + PICS group had longer hospital stay, worse prognosis and more adverse outcomes. Multivariate analysis showed that final age, CRP on day 14 and 21, serum albumin on day 1 and 21 had an impact on the prognosis (P<0.05).
CONCLUSION: The clinical prognosis of the four groups decreased in order of NCCI+NPICS, CCI, PICS, CCI + PICS. Our finding of clinically isolated PICS may indicate that PICS acts as a inducement or independent factor to worsen the prognosis of CCI.
PMID:36383370 | DOI:10.1097/SHK.0000000000002035
