The Predisposition, Infection, Response and Organ Failure (Piro) Sepsis Classification System: Results of Hospital Mortality Using a Novel Concept and Methodological Approach

Detalhes bibliográficos
Autor(a) principal: Granja, Cristina
Data de Publicação: 2013
Outros Autores: Povoa, Pedro, Lobo, Cristina, Teixeira-Pinto, Armando M., Carneiro, António, da Costa Pereira, Altamiro
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.1371/journal.pone.0053885
Resumo: Cristina Lobo was financially supported by the Grant from Fundacao para a Ciencia e Tecnologia (PIC/IC/83312/2007). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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spelling The Predisposition, Infection, Response and Organ Failure (Piro) Sepsis Classification System: Results of Hospital Mortality Using a Novel Concept and Methodological ApproachCOMMUNITY-ACQUIRED PNEUMONIAINTENSIVE-CARE UNITSVENTILATOR-ASSOCIATED PNEUMONIAPRACTICE GUIDELINESNORTHERN-IRELANDSEPTIC SHOCKEPIDEMIOLOGYMANAGEMENTSCOREDYSFUNCTIONMedicine(all)Biochemistry, Genetics and Molecular Biology(all)Agricultural and Biological Sciences(all)SDG 3 - Good Health and Well-beingCristina Lobo was financially supported by the Grant from Fundacao para a Ciencia e Tecnologia (PIC/IC/83312/2007). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Introduction: PIRO is a conceptual classification system in which a number of demographic, clinical, biological and laboratory variables are used to stratify patients with sepsis in categories with different outcomes, including mortality rates. Objectives: To identify variables to be included in each component of PIRO aiming to improve the hospital mortality prediction. Methods: Patients were selected from the Portuguese ICU-admitted community-acquired sepsis study (SACiUCI). Variables concerning the R and O component included repeated measurements along the first five days in ICU stay. The trends of these variables were summarized as the initial value at day 1 (D1) and the slope of the tendency during the five days, using a linear mixed model. Logistic regression models were built to assess the best set of covariates that predicted hospital mortality. Results: A total of 891 patients (age 60±17 years, 64% men, 38% hospital mortality) were studied. Factors significantly associated with mortality for P component were gender, age, chronic liver failure, chronic renal failure and metastatic cancer; for I component were positive blood cultures, guideline concordant antibiotic therapy and health-care associated sepsis; for R component were C-reactive protein slope, D1 heart rate, heart rate slope, D1 neutrophils and neutrophils slope; for O component were D1 serum lactate, serum lactate slope, D1 SOFA and SOFA slope. The relative weight of each component of PIRO was calculated. The combination of these four results into a single-value predictor of hospital mortality presented an AUC-ROC 0.84 (IC95%:0.81-0.87) and a test of goodness-of-fit (Hosmer and Lemeshow) of p = 0.368. Conclusions: We identified specific variables associated with each of the four components of PIRO, including biomarkers and a dynamic view of the patient daily clinical course. This novel approach to PIRO concept and overall score can be a better predictor of mortality for patients with community-acquired sepsis admitted to ICUs.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Centro de Estudos de Doenças Crónicas (CEDOC)RUNGranja, CristinaPovoa, PedroLobo, CristinaTeixeira-Pinto, Armando M.Carneiro, Antónioda Costa Pereira, Altamiro2017-08-02T22:05:27Z2013-01-182013-01-18T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.1371/journal.pone.0053885eng1932-6203PURE: 2988366http://www.scopus.com/inward/record.url?scp=84872591132&partnerID=8YFLogxKhttps://doi.org/10.1371/journal.pone.0053885info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:10:03Zoai:run.unl.pt:10362/22433Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:27:17.907815Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv The Predisposition, Infection, Response and Organ Failure (Piro) Sepsis Classification System: Results of Hospital Mortality Using a Novel Concept and Methodological Approach
title The Predisposition, Infection, Response and Organ Failure (Piro) Sepsis Classification System: Results of Hospital Mortality Using a Novel Concept and Methodological Approach
spellingShingle The Predisposition, Infection, Response and Organ Failure (Piro) Sepsis Classification System: Results of Hospital Mortality Using a Novel Concept and Methodological Approach
Granja, Cristina
COMMUNITY-ACQUIRED PNEUMONIA
INTENSIVE-CARE UNITS
VENTILATOR-ASSOCIATED PNEUMONIA
PRACTICE GUIDELINES
NORTHERN-IRELAND
SEPTIC SHOCK
EPIDEMIOLOGY
MANAGEMENT
SCORE
DYSFUNCTION
Medicine(all)
Biochemistry, Genetics and Molecular Biology(all)
Agricultural and Biological Sciences(all)
SDG 3 - Good Health and Well-being
title_short The Predisposition, Infection, Response and Organ Failure (Piro) Sepsis Classification System: Results of Hospital Mortality Using a Novel Concept and Methodological Approach
title_full The Predisposition, Infection, Response and Organ Failure (Piro) Sepsis Classification System: Results of Hospital Mortality Using a Novel Concept and Methodological Approach
title_fullStr The Predisposition, Infection, Response and Organ Failure (Piro) Sepsis Classification System: Results of Hospital Mortality Using a Novel Concept and Methodological Approach
title_full_unstemmed The Predisposition, Infection, Response and Organ Failure (Piro) Sepsis Classification System: Results of Hospital Mortality Using a Novel Concept and Methodological Approach
title_sort The Predisposition, Infection, Response and Organ Failure (Piro) Sepsis Classification System: Results of Hospital Mortality Using a Novel Concept and Methodological Approach
author Granja, Cristina
author_facet Granja, Cristina
Povoa, Pedro
Lobo, Cristina
Teixeira-Pinto, Armando M.
Carneiro, António
da Costa Pereira, Altamiro
author_role author
author2 Povoa, Pedro
Lobo, Cristina
Teixeira-Pinto, Armando M.
Carneiro, António
da Costa Pereira, Altamiro
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
Centro de Estudos de Doenças Crónicas (CEDOC)
RUN
dc.contributor.author.fl_str_mv Granja, Cristina
Povoa, Pedro
Lobo, Cristina
Teixeira-Pinto, Armando M.
Carneiro, António
da Costa Pereira, Altamiro
dc.subject.por.fl_str_mv COMMUNITY-ACQUIRED PNEUMONIA
INTENSIVE-CARE UNITS
VENTILATOR-ASSOCIATED PNEUMONIA
PRACTICE GUIDELINES
NORTHERN-IRELAND
SEPTIC SHOCK
EPIDEMIOLOGY
MANAGEMENT
SCORE
DYSFUNCTION
Medicine(all)
Biochemistry, Genetics and Molecular Biology(all)
Agricultural and Biological Sciences(all)
SDG 3 - Good Health and Well-being
topic COMMUNITY-ACQUIRED PNEUMONIA
INTENSIVE-CARE UNITS
VENTILATOR-ASSOCIATED PNEUMONIA
PRACTICE GUIDELINES
NORTHERN-IRELAND
SEPTIC SHOCK
EPIDEMIOLOGY
MANAGEMENT
SCORE
DYSFUNCTION
Medicine(all)
Biochemistry, Genetics and Molecular Biology(all)
Agricultural and Biological Sciences(all)
SDG 3 - Good Health and Well-being
description Cristina Lobo was financially supported by the Grant from Fundacao para a Ciencia e Tecnologia (PIC/IC/83312/2007). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
publishDate 2013
dc.date.none.fl_str_mv 2013-01-18
2013-01-18T00:00:00Z
2017-08-02T22:05:27Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://doi.org/10.1371/journal.pone.0053885
url https://doi.org/10.1371/journal.pone.0053885
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1932-6203
PURE: 2988366
http://www.scopus.com/inward/record.url?scp=84872591132&partnerID=8YFLogxK
https://doi.org/10.1371/journal.pone.0053885
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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