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Association between trends in clinical variables and outcome in intensive care patients with faecal peritonitis: analysis of the GenOSept cohort

Overview of attention for article published in Critical Care, December 2015
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  • High Attention Score compared to outputs of the same age and source (80th percentile)

Mentioned by

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7 tweeters

Citations

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8 Dimensions

Readers on

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46 Mendeley
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Title
Association between trends in clinical variables and outcome in intensive care patients with faecal peritonitis: analysis of the GenOSept cohort
Published in
Critical Care, December 2015
DOI 10.1186/s13054-015-0931-8
Pubmed ID
Authors

Ascanio Tridente, Geraldine M Clarke, Andrew Walden, Anthony C Gordon, Paula Hutton, Jean-Daniel Chiche, Paul AH Holloway, Gary H Mills, Julian Bion, Frank Stüber, Christopher Garrard, Charles Hinds

Abstract

Patients admitted to intensive care following surgery for faecal peritonitis present particular challenges in terms of clinical management and risk assessment. Collaborating surgical and intensive care teams need shared perspectives on prognosis. We aimed to determine the relationship between dynamic assessment of trends in selected variables and outcomes. We analysed trends in physiological and laboratory variables during the first week of ICU stay in 977 patients from 102 centres across 16 European countries. The primary outcome was 6-month mortality. Secondary end-points were ICU, hospital and 28 day mortality. For each trend, Cox proportional hazards (PH) regression analyses, adjusted for age and gender, were performed for each endpoint. Trends remaining significant after Bonferroni correction for multiple testing were entered into a multivariate Cox PH model to determine independent associations with mortality. Trends over the first 7 days ICU stay independently associated with 6 month mortality were worsening thrombocytopaenia (mortality HR = 1.02, 95% CI 1.01-1.03, p < 0.001) and renal function (total daily urine output HR = 1.02, 95%CI 1.01-1.03, p < 0.001; renal SOFA sub-score HR = 0.87, 95%CI 0.75-0.99, p = 0.047), maximum bilirubin level (HR = 0.99, 95%CI 0.99-0.99, p = 0.02) and GCS SOFA sub-score (HR = 0.81, 95%CI 0.68-0.98, p = 0.028). Changes in renal function (total daily urine output and renal component of the SOFA score), GCS component of the SOFA score, total SOFA and worsening thrombocytopaenia were also independently associated with secondary outcomes (ICU, hospital and 28 day mortality). We detected the same pattern when analysing trends on days 2, 3 and 5. Dynamic trends in all other measured laboratory and physiological variables and in radiological findings failed to be retained as independently associated with outcome on multivariate analysis. Furthermore, changes in respiratory support, renal replacement therapy and inotrope and/or vasopressor requirements were not independently associated with any of the primary or secondary outcomes. Only deterioration in renal function, thrombocytopaenia and SOFA score over the first 2, 3, 5 and 7 days ICU stay were consistently associated with mortality at all endpoints. These findings may help to inform clinical decision making in patients with this common cause of critical illness.

Twitter Demographics

The data shown below were collected from the profiles of 7 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 46 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
New Zealand 1 2%
Sudan 1 2%
Brazil 1 2%
Unknown 43 93%

Demographic breakdown

Readers by professional status Count As %
Student > Postgraduate 7 15%
Other 5 11%
Student > Bachelor 5 11%
Researcher 5 11%
Student > Master 4 9%
Other 13 28%
Unknown 7 15%
Readers by discipline Count As %
Medicine and Dentistry 31 67%
Environmental Science 1 2%
Business, Management and Accounting 1 2%
Agricultural and Biological Sciences 1 2%
Nursing and Health Professions 1 2%
Other 2 4%
Unknown 9 20%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 June 2015.
All research outputs
#5,680,999
of 19,211,930 outputs
Outputs from Critical Care
#3,278
of 5,568 outputs
Outputs of similar age
#70,697
of 239,846 outputs
Outputs of similar age from Critical Care
#2
of 5 outputs
Altmetric has tracked 19,211,930 research outputs across all sources so far. This one has received more attention than most of these and is in the 70th percentile.
So far Altmetric has tracked 5,568 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 17.4. This one is in the 40th percentile – i.e., 40% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 239,846 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.
We're also able to compare this research output to 5 others from the same source and published within six weeks on either side of this one. This one has scored higher than 3 of them.