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ICU mortality was higher in patients with a "Persistent Dysfunction" pattern than in those with a "No Dysfunction" pattern (p = 0.03).
Duration of mechanical ventilation was higher in patients with a "Persistent Dysfunction" pattern than in those with a "No Dysfunction" pattern (p = 0.04).
Ptr,stim on admission was significantly lower in patients with an "Acquired Dysfunction" pattern than in those with a "No Dysfunction" pattern (p = 0.005).
Among patients without diaphragm dysfunction at the time of intubation, the duration of mechanical ventilation tended to be higher in those with an "Acquired Dysfunction" pattern than in those with a "No Dysfunction" pattern (p = 0.064).
Among the remaining 20 patients who did not present diaphragm dysfunction on admission, 11 (26 %) subsequently developed diaphragm dysfunction ("Acquired Dysfunction" pattern) and 9 (21 %) did not present any diaphragm dysfunction during the ICU stay ("No Dysfunction" pattern).
The severity of the different organ dysfunctions in sepsis and its correlation to mortality can be estimated by the sepsis-related organ failure assessment (SOFA) score, which covers six different organ systems (and parameters) graded from 0 (no dysfunction) to 4 (severe dysfunction/failure), including the liver (bilirubin) and the kidney (creatinine) [12].
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In order to test the McSad psychometrically, each domain was assigned a score from 1 (no dysfunctioning) to 4 (severe dysfunctioning).
Serum lactate improved accuracy for values higher than 4 mmol/L in the no-dysfunction and septic shock groups.
This improvement occurred in the severe sepsis and septic shock groups (Sepsis-2) and the no-dysfunction and septic shock groups (Sepsis-3).
Sepsis-3 criteria clearly categorized septic patients along a spectrum of severity, since mortality increased from 7% in no-dysfunction-infected patients to 25 and 46% for sepsis and septic shock patients, respectively.
In comparison, lactate levels >4 mmol/L clearly marked increased mortality in both the severe sepsis and septic shock categories of Sepsis-2 and in the no-dysfunction and septic shock categories of Sepsis-3.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com