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Serum osmolality and outcome in intensive care unit patients.
Acta Anaesthesiol Scand. 2006 Sep; 50(8):970-7.AA

Abstract

BACKGROUND

The aim of the present study was to compare 16 routine clinical and laboratory parameters, acute physiologic and chronic health evaluation (APACHE) and sequential organ failure assessment (SOFA) score for their value in predicting mortality during hospital stay in patients admitted to a general intensive care unit (ICU).

METHODS

A retrospective observational clinical study was carried out in a 15-bed ICU in a university hospital. Nine hundred and thirty-three consecutive patients with ICU stay > 24 h (36.2% surgical, 29.1% medical and 34.7% trauma) were observed. Blood sampling, patient surveillance and data collection were performed. The primary outcome was mortality in the hospital. We used receiver operating characteristic (ROC) analyses and logistic regression to compare the 16 relevant parameters, APACHE II and SOFA scores.

RESULTS

Two hundred and thirty-three out of the 933 patients died (mortality 25.0%). One laboratory parameter, serum osmolality [area under the curve (AUC) 0.732] had a predictive value for mortality which lay between that of APACHE II (AUC 0.784) and SOFA (AUC 0.720) scores. When outcome prediction was restricted to long-term patients (ICU stay > 5 days), serum osmolality (AUC 0.711) performed better than either of the standard scores (APACHE AUC 0.655, SOFA AUC 0.636). Using logistic regression analysis, the association of clinical parameters, age and diagnosis group with mortality was determined.

CONCLUSION

Elevated serum osmolality at ICU admission is associated with an increased mortality risk in critically ill patients. Serum osmolality is cheaper and more rapid to determine than the scoring systems. However, further studies are needed to evaluate the predictive value of serum osmolality in different patient populations.

Authors+Show Affiliations

Institute for Mathematics and Informatics, Ernst-Moritz-Arndt-University, Greifswald, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16923092

Citation

Holtfreter, B, et al. "Serum Osmolality and Outcome in Intensive Care Unit Patients." Acta Anaesthesiologica Scandinavica, vol. 50, no. 8, 2006, pp. 970-7.
Holtfreter B, Bandt C, Kuhn SO, et al. Serum osmolality and outcome in intensive care unit patients. Acta Anaesthesiol Scand. 2006;50(8):970-7.
Holtfreter, B., Bandt, C., Kuhn, S. O., Grunwald, U., Lehmann, C., Schütt, C., & Gründling, M. (2006). Serum osmolality and outcome in intensive care unit patients. Acta Anaesthesiologica Scandinavica, 50(8), 970-7.
Holtfreter B, et al. Serum Osmolality and Outcome in Intensive Care Unit Patients. Acta Anaesthesiol Scand. 2006;50(8):970-7. PubMed PMID: 16923092.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum osmolality and outcome in intensive care unit patients. AU - Holtfreter,B, AU - Bandt,C, AU - Kuhn,S-O, AU - Grunwald,U, AU - Lehmann,C, AU - Schütt,C, AU - Gründling,M, PY - 2006/8/23/pubmed PY - 2007/2/17/medline PY - 2006/8/23/entrez SP - 970 EP - 7 JF - Acta anaesthesiologica Scandinavica JO - Acta Anaesthesiol Scand VL - 50 IS - 8 N2 - BACKGROUND: The aim of the present study was to compare 16 routine clinical and laboratory parameters, acute physiologic and chronic health evaluation (APACHE) and sequential organ failure assessment (SOFA) score for their value in predicting mortality during hospital stay in patients admitted to a general intensive care unit (ICU). METHODS: A retrospective observational clinical study was carried out in a 15-bed ICU in a university hospital. Nine hundred and thirty-three consecutive patients with ICU stay > 24 h (36.2% surgical, 29.1% medical and 34.7% trauma) were observed. Blood sampling, patient surveillance and data collection were performed. The primary outcome was mortality in the hospital. We used receiver operating characteristic (ROC) analyses and logistic regression to compare the 16 relevant parameters, APACHE II and SOFA scores. RESULTS: Two hundred and thirty-three out of the 933 patients died (mortality 25.0%). One laboratory parameter, serum osmolality [area under the curve (AUC) 0.732] had a predictive value for mortality which lay between that of APACHE II (AUC 0.784) and SOFA (AUC 0.720) scores. When outcome prediction was restricted to long-term patients (ICU stay > 5 days), serum osmolality (AUC 0.711) performed better than either of the standard scores (APACHE AUC 0.655, SOFA AUC 0.636). Using logistic regression analysis, the association of clinical parameters, age and diagnosis group with mortality was determined. CONCLUSION: Elevated serum osmolality at ICU admission is associated with an increased mortality risk in critically ill patients. Serum osmolality is cheaper and more rapid to determine than the scoring systems. However, further studies are needed to evaluate the predictive value of serum osmolality in different patient populations. SN - 0001-5172 UR - https://www.unboundmedicine.com/medline/citation/16923092/Serum_osmolality_and_outcome_in_intensive_care_unit_patients_ DB - PRIME DP - Unbound Medicine ER -