Het voorspellen van de ernst van sepsis bij patiënten op de CSO.

Wolffensperger, A. (Anna) (2013) Het voorspellen van de ernst van sepsis bij patiënten op de CSO. thesis, Medicine.

Text WolffenspergerA.pdf Restricted to Registered users only Download (473kB)

Abstract

Study objective: to determine which scoring system predicts best the clinical outcome (mortality, ICU-admission and MOF) of sepsis syndromes. Methods: prospective observational pilot study at the emergency department of the UMCG with patients with suspected or confirmed sepsis. The objective was to determine if clinical jugdement, SIRS criteria or PIRO score can predict clinical outcome in sepsis. Patients were screened with the SIRS criteria and included. Doctor and nurse gave their clinical judgement of the patient’s condition on a 1 (not sick) to 10 (very sick) scale as soon as possible after arrivel at the ED. The investigator retrospectively calculated the PIRO score. Statistical analysis was done in SPSS (ANOVA). Results: 80 patients were included. 45 (56,2%) had mild sepsis, 32 (40,0%) had severe sepsis and 3 (3,8%) had septic shock. Severe sepsis and septic shock groups were merged for the sake of statistical power. The PIRO score differed significantly between mild and severe sepsis groups for mortality (p=0,047), ICU admission (p=0,014) en MOF (p=0,000). The clinical judgment score of the doctor differed significantly between mild and severe sepsis groups for mortality (p=0,03), ICU admission (p=0,000) en MOF (p=0,037). The clinical judgment score of the nurse differed significantly between mild and severe sepsis groups for ICU admission (p=0,006), but not for mortality and MOF. The SIRS criteria had no correlation with mortality, but had a correlation with ICU admission and MOF. Conclusion: the PIRO score seems to differ when someone has mild or severe sepsis. The clinical judgment of doctors is also different depending on the sepsis stage. The clinical judgment of nurses is less reliable. The differences are not very pronounced, probably because of the small number of patients in this study. Large scale studies are needed to determine whether or not the differences are clinically relevant.

Item Type:	Thesis (Thesis)
Supervisor name:	Ligtenberg, dr. J.J.M.
Supervisor name:	Meurs, Dr. M. Van
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:58
Last Modified:	25 Jun 2020 10:58
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1845

Actions (login required)

View Item