外傷と救急治療 オープンアクセス

抽象的な

Clinical and Laboratory Predictors of Mortality in Septic Patients on ICU Admission.

Georgia-Athanasia Lavranou and Spyros Zakynthinos

Sepsis is one of the leading causes of death for patients in the Intensive Care Unit (ICU). In the case of suspected or proven infection, sepsis is defined with increasing severity as (uncomplicated) sepsis, severe sepsis and septic shock. The present review aimed to present and discuss the literature about the prognostic value for survival or death of clinical and laboratory parameters in septic patients on ICU admission. Among laboratory parameters special attention was paid for the various disorders of the blood coagulation system and the immune and inflammatory response (i.e., levels of pro- and anti-inflammatory cytokines and other biomarkers of sepsis). We concluded that in patients admitted to the ICU with a suspected or confirmed diagnosis of infection and sepsis, the various clinico- laboratory scores and measurements [i.e., Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, Lung Injury Score (LIS), and PaO₂/FiO₂) seem to have a significant predictive value in terms of survival or death in almost all three groups of septic patients. Ant thrombin III and Protein C activity, as well as lactate level, have prognostic value in patients with severe sepsis or septic shock. Coagulation factors’ activity, as well as cytokine, procalcitonin and thrombopoietin levels have some predictive value only in distinct groups of septic patients.