Internal Medicine Intensive Care Unit Research Articles

Vitamin D levels in patients admitted to the internal medicine intensive care unit and the association with mortality and other clinical outcomes

Vitamin D levels in patients admitted to the internal medicine intensive care unit and the association with mortality and other clinical outcomes

The power of serum albumin levels in predicting mortality in critical patients

Aims: Given the presence of comorbidities and critical illnesses in patients admitted to the intensive care unit (ICU), it is imperative to accurately forecast their prognosis and mortality in order to effectively plan and administer their therapies. Decreased serum albumin level is associated with adverse clinical outcomes. We designed this study to evaluate the prognostic value of decreased serum albumin level and its association with age in critically ill patients based on data obtained from the intensive care unit (ICU). Methods: Data of patients followed between June 2022 and December 2023 in the Internal Medicine ICU of Akdeniz University Hospital were retrospectively reviewed. Albumin, C-reactive protein (CRP), Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores were documented within the initial 24 hours following admission to the ICU. Delta Albumin expression was used to express the changes between albumin values. The relationship between the obtained data and age was examined and compared between the surviving and deceased patient groups. Results: 300 patients were included in the study. Albumin levels were significantly lower at admission compared to discharge in both the survival and deceased groups (both p

Comparison of nutritional risk indices (PNI, GNRI, mNUTRIC) and HALP score in predicting adverse clinical outcomes in older patients staying in an intensive care unit.

Malnutrition among critically ill older patients is a frequent problem in intensive care units (ICUs) and is associated with a higher risk of hospital/ICU length of stay (LOS) and mortality. The aim of this study was to evaluate malnutrition in older patients staying in an ICU using the hemoglobin, albumin, lymphocyte, platelet (HALP) score, modified nutrition risk in the critically Ill (mNUTRIC), prognostic nutritional index (PNI), and geriatric nutritional risk index (GNRI) and to determine the consistency between these tools and their association with clinical outcomes. This cross-sectional retrospective, observational, hospital-based study included 153 older patients (≥65 years of age), who were admitted to an internal medicine ICU. Sequential organ failure assessment (SOFA) scores and acute physiology and chronic health evaluation (APACHE) II were used to assess disease severity. Nutritional status was evaluated using mNUTRIC, GNRI, PNI, and HALP scores, and their association with ICU LOS and mortality was evaluated using ROC and regression analyses. The mortality rate of the patients was 43.1%. The risk of malnutrition was higher among non-survivors, with mNUTRIC scores showing a significant difference between the groups. The scores for all indices, except HALP, showed significant differences between the groups. APACHE-II, SOFA, and mNUTRIC were the strongest prognostic indices for ICU mortality, with mNUTRIC having the highest sensitivity and negative predictive value. The HALP score was not associated with ICU LOS or a significant prognostic factor for mortality. All indices except HALP were good indicators of clinical outcomes in the study population including older patients. Prospective studies in larger and specific patient populations are needed to draw a strict conclusion in this subject.

Exploring intensivist involvement: Patient characteristics, interventions and outcomes.

Intensivists play a critical role in the management of intensive care units (ICUs) and in providing high quality care. While international guidelines recommend intensivist staffing for improved patient outcomes, there is a shortage of qualified intensivists in many regions, including Türkiye. This study aimed to assess the impact of introducing a full-time intensivist to a medical ICU on patient characteristics, outcomes, and ICU interventions. This retrospective study analyzed data from the Internal Medicine ICU at Van Yüzüncü Yıl University Dursun Odabaş Medical Center over two periods: Pre- and post-intensivist recruitment. The study included adult patients admitted to the ICU from February 2018 to January 2020. Patient demographics, reasons for ICU admission, APACHE-II and SOFA scores, ICU interventions, and outcomes were recorded and compared between the two periods. Of the 868 patients admitted during the study period, 820 were included in the analysis. There were no significant differences in demographic characteristics between the pre- and post-intensivist periods. However, patients in the post-intensivist period had higher APACHE-II and SOFA scores. Intensive care units mortality rates were comparable between the two periods. The post-intensivist period saw increased use of invasive mechanical ventilation and non-invasive ventilation compared to the pre-intensivist period. Renal replacement therapy usage and enteral nutrition provision also increased in the post-intensivist period. ICU and hospital lengths of stay remained similar between the two periods. The introduction of a full-time intensivist to the medical ICU led to changes in ICU interventions, including increased use of mechanical ventilation and renal replacement therapy. Despite these changes, ICU mortality rates remained unchanged. Further research is needed to explore the longterm impact of intensivist staffing on patient outcomes in Türkiye.

Comparison of the Effects of Apheresis and Pooled Platelet Transfusions on Platelet Count

Background: To compare the increase in platelet count after the transfusion of apheresis and pooled platelet suspensions among patients in the internal medicine intensive care unit. Methods Patients who received platelet suspension transfusions and were followed up at the internal medicine intensive care unit at Mehmet Akif Inan Training and Research Hospital were evaluated. The patient's platelet counts were administered apheresis, and pooled platelet suspensions were recorded before and after transfusion. The increase in platelet count was calculated. The two groups were statistically compared. Results: A total of 4,701 platelet suspension transfusions were performed at our hospital between January 1, 2020, and December 31, 2023. Of these transfusions, 2,990 belonged to pooled platelet suspensions and 1,711 to apheresis platelet suspensions. Conclusion: Platelet suspension transfusion is frequently used in patients receiving internal medicine intensive care. However, there is an ongoing debate concerning whether apheresis or pooled platelet transfusion is more effective in increasing platelet count. In this study, we found a significantly higher increase in platelet count among patients in the internal medicine intensive care unit after apheresis platelet suspension transfusion than pooled platelet suspension transfusion.

Effect of fosfomycin-induced hypernatremia on patients' hospital stay length and survival.

Hypernatremia is a possible side effect of intravenous fosfomycin. The aim of this study was to investigate the effects of changes in sodium (Na) levels on hospital stay and survival in patients hospitalized in the intensive care unit receiving fosfomycin. This study was conducted retrospectively on the files of patients over the age of 60, who were admitted to the Internal Medicine Intensive Care Unit. Plasma sodium levels were observed and documented over a period of 14days. The patients were divided into two groups (Hypernatremia group Na > 145 mEq/L vs normonatremia group 135-145mEq/L). In addition, daily sodium changes were noted for 14days in patients. The mean age of the patients was 75years. Hospitalization days were longer for hypernatremia patients (31.5days vs 41days, p = 0.003). Patients with hypernatremia had an extended duration of stay in the intensive care unit. (21days vs 31days p = 0.002). The 1-month survival rate was 61.4% in patients with hypernatremia and 24.9% in patients without hypernatremia (p = 0.004). The absence of hypernatremia increases mortality by 2.09 times (95% CI 1.35-3.23). When discharge and mortality rates were analyzed according to sodium fluctuation, discharged patients exhibited a lower sodium fluctuation (4min/max (-10/19) vs 6min/max (-16/32) p < 0.001). In conclusion, the strength of our study is that it specifically focuses on the consequences of the sodium fluctuation on patient management and provides results.

Comparison of non-COVID-19 critically ill patients between pre-pandemic and pandemic period admitted from emergency department to internal medicine intensive care unit

Aim: During the COVID-19 pandemic, a large number of intensive care unit beds have been organized for critically ill COVID-19 patients. However, the need for intensive care for non-COVID-19 critical patients continues. In our study, we aimed to compare non-COVID-19 critically ill patients admitted to the internal medicine intensive care unit from the emergency department before and during the pandemic period.&#x0D; Materials and Methods: Patients who were admitted to the internal medicine intensive care unit from the emergency department were grouped as pre-pandemic (March 2018-March 2020) and during the pandemic (March 2020-March 2022) and compared retrospectively in terms of the number of hospitalisations, demographic characteristics, length of intensive care unit stay and mortality.&#x0D; Results: The number of emergency department patient admissions other than surgical reasons was 579.657 during the study period. 63.33 % of these patients were admitted before the pandemic and 36.67% during the pandemic period. The number of patients included in our study was 493 before the pandemic and 460 during the pandemic period. Median age was 61 (30) in the pre-pandemic period and 64 (26.8) in the pandemic period, p=0.022. There was no significant difference in terms of comorbidities. The main reason for hospitalisation was similar and sepsis was the leading reason for hospitalisation. The frequency of acute renal failure in intensive care unit was significantly higher during the pandemic period. Mortality was 25.2% before the pandemic and 24.3% during the pandemic period, p=0.760.&#x0D; Conclusion: Although emergency department admissions decreased, the number of non-COVID-19 internal medicine intensive care unit hospitalisations did not decrease. This situation reveals the importance of organising intensive care beds for hospitalisation for non-COVID-19 reasons in order not to disrupt health services during the pandemic period.

Construction of a standardized training system for hospital infection prevention and control for new medical staff in internal medicine ICUs based on the Delphi method

In China, studies have shown nosocomial infections contribute to increased mortality rates, prolonged hospital stays, and added financial burdens for patients. Previous studies have demonstrated that effective infection control training can enhance the quality of infection control practices, particularly in intensive care unit (ICU) settings. However, there is currently no universally accepted training mode or program that adequately addresses the specific needs of ICU medical staff regarding nosocomial infection control. The objective of this study was to develop a standardized training system for preventing and controlling hospital-acquired infections among new medical staff in the internal medicine ICU. Our methodology encompassed an extensive literature review, technical interviews focusing on key events, semi-structured in-depth interviews, and two rounds of Delphi expert correspondence. We employed intentional sampling to select 16 experts for the Delphi expert consultation. Indicators were chosen based on an average importance score of &gt;3.5 and a coefficient of variation of &lt;0.25. The weight of each indicator was determined using the analytic hierarchy process. The efficacy of the two rounds of questionnaires was also evaluated. Our findings revealed that the questionnaires achieved a 100% effective recovery rate, with expert authority coefficients of 0.96 and 0.90. The Kendall coordination coefficients for the first-, second-, and third-level indicators in the initial round of expert consultation questionnaires were 0.440, 0.204, and 0.386 (P &lt; 0.001), respectively. In the second round of expert consultation questionnaires, the Kendall coordination coefficients for the first, second, and third-level indicators were 0.562, 0.467, and 0.556 (P &lt; 0.001), respectively. The final training model consisted of four first-level indicators (hospital infection prevention and control training content, training methods/forms, assessment content, and evaluation indicators), 26 second-level indicators, and 44 third-level indicators. In conclusion, the proposed standardized training system for infection prevention and control among new medical staff in the internal medicine ICU is both scientifically sound and practical, which can contribute to improved patient safety, reduced healthcare costs, and enhanced overall quality of care in internal medicine ICUs. Moreover, it can serve as a framework for future training projects.

The Frequency of Musculoskeletal Pain in Nurses Working in Internal Medicine Intensive Care Unit and Related Factors

Background: The primary purpose of this study was to determine the frequency of musculoskeletal pain in nurses working in the internal medicine intensive care unit and to determine whether there were differences between nurses working in the internal medicine clinic. In addition, it was aimed to determine the individual and professional risk factors that will cause musculoskeletal pain in nurses working in the internal medicine intensive care unit.&#x0D; Material and Methods: After evaluating eligibility, 82 volunteer nurses, 36 working in the internal medicine intensive care unit and 46 working in the internal medicine clinic, were included in this single-centre, cross-sectional and descriptive study. The demographic characteristics of the participants, their regular exercise status and the factors related to their working conditions were determined by the questionnaire form created by the researchers.&#x0D; Results: Musculoskeletal pain was detected in 61.11% of internal medicine intensive care nurses. There was no statistical difference between the internal medicine intensive care and clinical nurses regarding musculoskeletal pain (p&gt;0.05). A statistically significant relationship was found between the situation of changing the patient's clothes and positioning the patient and the occurrence of musculoskeletal pain (p

The effect of audiobooks on sleep quality and vital signs in intensive care patients

ObjectiveImproving sleep quality in the intensive care unit is significant for the recovery process. This study investigated the effect of listening to audiobooks on sleep quality and vital signs in intensive care patients. MethodsThis quasi-experimental study utilized the pre-posttest design, involving control and intervention groups. The study was conducted in the internal medicine intensive care unit of a hospital in Turkey between January–June 2022. Standard nursing care was given to both groups on the first night, and the Sleep Evaluation Form and Richard Campbell Sleep Scale were used to measure sleep quality in the morning. On the second day, the intervention group listened to a recorded story, and the control group had standard care. Sleep quality and vital signs were measured again. ResultsData from 56 participants were analyzed. Noise (96.4%), light (69.6%), unfamiliar environment (64.8%), concerns about illness (33.9%), and care and treatments (58.9%) are the main causes of sleep disruption. The effect of these factors decreased in the intervention group after the Audiobook Listening Practice, which significantly improved the sleep quality of the ICU patients (p < 0.001). Among the vital signs, a significant difference was found in pulse and blood pressure (p < 0.001), while no changes were observed in temperature and respiratory rate in time group interaction (p > 0.05). ConclusionsThe Audiobook Listening Practice improved sleep quality and life parameters in the ICU. Nurses can use the practice to improve sleep quality in intensive care units. Implications for clinical practiceEvidence-based studies are needed to improve the sleep quality of patients in intensive care units, to ensure clinical improvement, and to reduce the length of stay at hospital. The practice is effective in manipulating environmental stressors. This low-cost method significantly improves patient care activities. It is recommended to integrate such complementary activities into intensive care units, to train nurses about the practice, and to support the practice with new studies.

Tekrarlayan başarısız weaning ve uzamış apne ile tanı konulan yaşlı myastenia gravis hastası

Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder caused by the development of antibodies to nicotinic acetylcholine receptors. The disease characterized by variable muscle weakness worsening with exercise. Although most patients have neurological signs and symptoms, respiratory symptoms occur in the late stages of the disease. However, rarely, respiratory failure may be the first symptom in some undiagnosed patients. We report the case of an elderly patient who was admitted with respiratory failure and intubated and transferred to the internal medicine intensive care unit. Two days after intubation, when she was awake and met the extubation criteria, endotracheal tube was successfully removed. At this time, her vital signs were normal. However, next day, her arterial blood gas CO2 rose and he became drowsy, requiring re-intubation. This situation repeated on the fifth and 16th days of her hospitalization and prolonged apnea was observed after intubation with rocuronium. All other causes of failed extubation, such as sepsis and pneumonia, were ruled out. During follow-up, ptosis was detected in the right eye and acetylcholine receptor antibody was positive. On the 30th day of the follow-up, methylprednisolone 1mg/kg and pyridostigmine 240 mg/day was initiated. The patient, whose spontaneous respiration was sufficient, was extubated and taken to the neurology clinic for further examination and treatment.

Examining the Nutrition, Oral Mucositis, and Gastrointestinal System Symptoms of Intensive Care Units Patients Receiving Enteral and Parenteral Nutrition.

This descriptive study aims to examine the complications that might develop in patients who receive enteral or parenteral nutrition treatment in intensive care unit in this process and to examine the nutritional status, oral mucositis, and gastrointestinal system symptoms among patients who receive enteral or parenteral nutrition treatment in intensive care unit. A sample of this study consists of 104 patients who received enteral or parenteral nutrition treatment in intensive care units between January and June 2019. The data were collected face to face by using Sociodemographic Form, constipation severity scale, Mini Nutritional Assessment Scale, Mucositis Assessment Scale, visual analog scale, and gastrointestinal system Symptoms Scale. The results were calculated as numbers, percentage, SD, and mean values. Among the participating patients, 67.4% were older than 65 years, 55.8% were female, 42.3% were receiving treatment in internal medicine intensive care units, and 43.4% had severe mucositis. It was determined that 31.7% of the patients receiving treatment in intensive care units required nutrition treatment. It was determined that patients receiving parenteral nutrition had more symptoms such as gastrointestinal system symptoms, mucositis, constipation, and colonic inertia. It was determined that when compared to the patients receiving enteral nutrition, the patients receiving parenteral nutrition had higher scores in mucositis, visual analog scale pain, Mini Nutritional Assessment Test, constipation, obstructive defecation, colonic inertia, and gastrointestinal symptom total scores.

#3242 OUTCOMES OF THERAPEUTIC PLASMA EXCHANGE: A ONE-YEAR EXPERIENCE IN AN INTERNAL MEDICINE INTENSIVE CARE UNIT

Abstract Background and Aims There is uncertainty regarding the best indication, device type, frequency, length of time, kind of replacement fluid, and criteria for ceasing therapeutic plasma exchange (TPE) for various disorders. TPE is an intrusive technique that has the potential to save lives, but it also has a risk of unfavorable outcomes and complications, necessitating close supervision by professional teams. In the intensive care unit (ICU), there are three categories of indications for TPE: (1) absolute, well-established, and evidence-based, for which TPE is recognized as first-line therapy; (2) relative; for which TPE is a recognized second-line treatment (alone or in combination) and (3) rescue therapy; for which TPE is used with a limited or theoretical evidence base. The purpose of this study is to continue our evaluation of the outcome of nephrology care in internal medicine ICU regarding bedside membrane therapeutic plasma exchange. Method In the continuity of our previous work in the analysis of the outcome of TPE. From August 2021 to August 2022, 425 membrane plasma exchange sessions were performed on 69 patients in the internal medicine department's ICU-Cairo University Hospitals-Egypt. Results Closely similar to what we found before; the most frequent diagnosis was thrombotic microangiopathies (24 (34.8%) patients) with complete recovery seen in 18/24 patients (75%); followed by systemic vasculitis with pulmonary renal involvement (14 (20.3%) patients) with partial remission was seen in 9/14 patients (64.3%); Guillain-Barré syndrome (13 (18.8%) patients) with complete recovery was seen in 8/13 patients (61.5%); Proliferative Lupus Nephritis with crescents [10 (14.5%) patients] with partial remission in 8/10 patients (80%), and myasthenia gravis [8 (11.6%) patients] with complete recovery in 6/8 patients (75%). Hypotension occurred during 69/425 (16.2%) sessions and hypocalcemia in 8/69 (11.5%) patients during treatment. Infection of vascular access occurred in 4/69 (5.8%) patients. 6/69 (8.7%) patients died during their stay in ICU none during treatment with TPE, all of them were diagnosed to have severe sepsis as a cause of death. Conclusion According to our experience, membrane therapeutic plasma exchange is a successful and secure treatment for a variety of illnesses including thrombotic microangiopathies, systemic vasculitis, myasthenia gravis, proliferative lupus nephritis, and Guillain-Barré syndrome. The main reason for death was sepsis.

Predictability performance of urinary C–C motif chemokine ligand 14 and renal resistive index for persistent sepsis-associated acute kidney injury in ICU patients

ObjectivesThe performance of renal resistance index (RRI) in predicting persistent sepsis-associated acute kidney injury (S-AKI) remains debatable, and the value of urinary C–C motif chemokine ligand 14 (CCL14) in predicting persistent S-AKI has not been validated yet. Therefore, we aimed to determine the applicability of a urinary biomarker CCL14 for the early detection of persistent S-AKI. Furthermore, the use of RRI obtained from renal Doppler ultrasonography was applied to differentiate transient from persistent S-AKI. Finally, we aimed to evaluate the use of these techniques in predicting different subtypes of S-AKI.MethodsThis prospective observational study was conducted at the internal medicine intensive care unit (ICU) of a university hospital. The RRI was determined within 12 h of ICU admission and the urinary CCL14 was evaluated at T0, T6, T12, and T24. The reversibility of renal dysfunction was assessed within 48 h. The receiver operating characteristic curves were then plotted to assess the diagnostic efficacy of the RRI and urinary CCL14 in predicting persistent S-AKI.ResultsOut of 48 patients, 23 developed persistent S-AKI upon admission. The RRI was higher in the persistent S-AKI group (P = 0.02) and the RRI ≥ 0.679 could predict persistent S-AKI with an area under the receiver operating characteristic curve of 0.79 (95% CI 0.65–0.93), a sensitivity of 91.30% (95% CI 70–98%), and a specificity of 65.20% (95% CI 43–83%). Urinary CCL14 was not significantly different between the two groups at the tested period, showing poor diagnostic performance at T0, T6, T12, and T24, with areas under the receiver operating characteristic curves of 0.56 (95% CI 0.38–0.73), 0.62 (95% CI 0.46–0.79), 0.52 (95% CI 0.35–0.68), and 0.60 (95% CI 0.43–0.77), respectively.ConclusionsThe RRI obtained from renal Doppler ultrasound is extremely effective in predicting persistent S-AKI in critically ill patients, and urinary CCL14 could not distinguish between transient and persistent S-AKIs.

Evaluation of Continuous Renal Replacement Therapy Results Applied in the Intensive Care Unit

Purpose: Acute kidney injury diagnosed patients are in need of renal replacement therapy (RRT). Continuous RRT is believed to be safer because the rates of fluid and solute removal are slower than with intermittent hemodialysis. In many centers, CRRT is preferred in special conditions such as increased cranial pressure, sepsis, burns, heart and liver failure. In our study, we present one year data of CRRT usage in our ICU.&#x0D; Materials and methods: This study included the patients who admitted to the Internal Medicine Intensive Care Unit of our university between January 2019 and June 2020. Among these patients, those over 18 years of age and those who had acute renal failure during their hospitalization and received continuous renal replacement therapy were included in the study.&#x0D; Results: Mean SOFA scores at admission were 2.7 which is an indication for severe disease. Lengths of ICU stay were long and approximately 77 percent of these patients died in ICU. When the comorbid conditions of the patients were examined, it was seen that oncological diseases were the most common. It was followed by hypertension, diabetes mellitus and heart diseases. Considering the KDIGO scores of the patients diagnosed with AKI, it was seen that 60 percent of them were grade 5. Treatment could be applied for an average of 25 hours. &#x0D; Conclusion: Indications, timing and benefits of CRRT are the questions that need to be research and yet remained unsolved. With evolving of technology, CRRT will be our most useful helper in ICUs.

Comparison of predictive scoring systems in patients hospitalized in the internal medicine intensive care unit

Aim: Various scoring systems have been developed to predict mortality, disease severity, and length of stay of patients in intensive care units. It is important to demonstrate the validity of these scores in the society in which they are used. This study aims to evaluate the effects of The Acute Physiologic and Chronic Evaluation (APACHE)-II, APACHE-IV, The Simplified Acute Physiologic Score (SAPS), and Mortality Prediction Model (MPM0) scores on mortality in the internal medicine intensive care unit. &#x0D; Material and Method: The patients who were followed up in an internal medicine intensive care unit between June 2021 and December 2021 in a tertiary hospital in Turkey were included in this study. The scores were calculated at the time they were admitted to the intensive care unit. 115 patients who were followed up in the internal medicine intensive care unit for 6 months were included. The patients were divided into two groups alive or deceased. 52 (45.2%) patients in the survivor group and 63 (54.8%) patients in the deceased group were included. Patients received no study-related medical intervention. &#x0D; Results: When all four prognostic scoring systems were analyzed according to the median cut-off values, rising values ​​were related to mortality with statistical significance (p

Ketiapine Bağlı Myokardit

This article reports myocarditis related to overdose of quetiapine. An 18-year-old female patient who used 25 mg of quetiapine for anxiety disorder attempted suicide with twenty quetiapine pills. The patient developed palpitations, shortness of breath, pleuritic chest pain, and confusion in the emergency room. ST-elevation and right bundle branch block were detected on D1-aVL lead in the patient's ECG. The cardiac markers were significantly elevated. The patient was hospitalized and treated in the internal medicine intensive care unit. Drug-induced myocarditis was resolved by two weeks of treatment. This case report presents a case of myocarditis induced by quetiapine overdose.

Correlation of ICU Nurses' Cognitive Level with Their Attitude and Behavior toward the Prevention of Ventilator-Associated Pneumonia.

Objective To analyze the correlation of ICU nurses' cognitive level with their attitude and behavior toward the prevention of ventilator-associated pneumonia (VAP). Methods A total of 90 ICU nurses working in the adult internal medicine ICU, adult surgery ICU, subacute respiratory care ward, etc. from January 2018 to June 2019 were chosen as the subjects to carry out questionnaire survey with the cognition scale, and the correlation analysis on their cognitive level, attitude, and behavior toward the prevention of VAP was conducted. Results The linear fitting analysis finding showed that the cognitive level presented a positive correlation with the attitude score and behavior score (R2 = 0.668, 0.734). Conclusion Improving ICU nurses' cognitive level, attitude, and behavior toward preventing VAP is conducive to the upgrade of their quality of nursing services. In addition, the ICU nurses' cognitive level is positively correlated with their attitude and behavior.

The prognostic nutritional index is associated with mortality of patients in intensive care unit

Background/Aim: It has been reported that the prognostic nutritional index (PNI) is ), an immunonutritional index, associated with poor prognosis, especially in cardiovascular and malignant diseases. However, the clinical significance of PNI in intensive care (ICU) patients remains unclear. In this study, we aimed to measure the predictive value of the PNI in predicting mortality in patients hospitalized in the ICU. Methods: A total of 80 patients hospitalized in the internal medicine ICU of our hospital between January 2021 and September 2021 were included in this observational cohort study. The patients' demographic characteristics, comorbidities, laboratory parameters, need for and duration of mechanical ventilation, length of stay in ICU, and mortality rates were retrospectively analyzed. The patients were divided into two groups according to their survival; the first group comprised of survivors while the second group comprised of those who died in the ICU. The two groups were compared in terms of all variables. Results: The mean age of all subjects included in the study was 63 (18.2) years and 50% (n=40) were female and 50% (n=40) were male. When patients are grouped as survivors and non-survivors, the mean age and sex distribution were similar (P=0.23, P=0.27, respectively). The median follow-up period of the patients was 5 (IQR 3-11) days and the mortality rate was 38.7% (n=31). Those in the non-survivor group had higher APACHE II and SOFA scores (P=0.02, P

Prognostic value of the lactate/albumin ratio for predicting mortality in patients with pneumosepsis in intensive care units.

The lactate/albumin (L/A) ratio correlates with Acute Physiology and Chronic Health Evaluation 2 (APACHE-2) and Sequential Organ Failure Assessment (SOFA) scores. This study examined whether the L/A ratio has prognostic value in a larger group of critically ill (adult) patients admitted to an intensive care unit (ICU) due to pneumosepsis.This retrospective study analyzed the data of 273 patients with pneumosepsis admitted to the Internal Medicine ICU of Adana City Training and Research Hospital between 2018 and 2020. Patients diagnosed with pneumosepsis were included in the study. The data were obtained from the hospital system. Patients who had cancer, who were pregnant, and patients whose necessary data could not obtain for the study were excluded from the study.The L/A ratio was superior to lactate or albumin alone as a predictor of mortality. Furthermore, this result was valid for patients with kidney and hepatic dysfunction. A correlation occurred between the L/A ratio and APACHE-2 and SOFA scores in patients with pneumosepsis.The L/A ratio can be an independent predictor of mortality in patients with pneumosepsis and patients with pneumosepsis with renal and hepatic dysfunction. The L/A ratio correlated positively with lactate levels and APACHE-2 and SOFA scores but negatively with albumin levels.